Fatal acetaminophen poisoning with hepatic microvesicular steatosis in a child after repeated administration of therapeutic doses
| Autor: | Bruno Turlin, Renaud Bouvet, Alain Baert, Aurélie Cauchois, Bernard Fromenty, Isabelle Morel, Thomas Gicquel |
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| Přispěvatelé: | Institut du droit public et de la science politique (IDPSP), Université de Rennes (UR), CHU Pontchaillou [Rennes], Nutrition, Métabolismes et Cancer (NuMeCan), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES), Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rennes 1 (UR1) |
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Pediatric acute-liver
medicine.medical_specialty Necrosis failureMicrovesicular steatosis [SDV]Life Sciences [q-bio] Encephalopathy Microvesicular Steatosis Respiratory chain 01 natural sciences Gastroenterology Pathology and Forensic Medicine 03 medical and health sciences 0302 clinical medicine Internal medicine Painkiller toxicity medicine 030216 legal & forensic medicine Fulminant hepatitis Hepatitis medicine.diagnostic_test business.industry Pediatric acute-liver failure 010401 analytical chemistry Microvesicular steatosis medicine.disease 3. Good health 0104 chemical sciences Acetaminophen Death Liver biopsy Acetaminophen-induced hepatotoxicity medicine.symptom business Law medicine.drug |
| Zdroj: | Forensic Science International Forensic Science International, 2020, 310, pp.110258. ⟨10.1016/j.forsciint.2020.110258⟩ Forensic Science International, Elsevier, 2020, 310, pp.110258. ⟨10.1016/j.forsciint.2020.110258⟩ |
| ISSN: | 0379-0738 |
| DOI: | 10.1016/j.forsciint.2020.110258⟩ |
| Popis: | International audience; Acetaminophen is the leading cause of acute liver failure worldwide following massive ingestion. We present here a fatal acute liver failure after repeated administration of four therapeutic doses of acetaminophen at 4-h intervals in a previously healthy 9-year-old female who presented dental pain after a facial trauma during sport practice. A diagnosis of paracetamol-induced hepatitis was deduced from the clinical picture of fulminant hepatitis and tubular necrosis, the encephalopathy with oedema and without signs of trauma. Liver biopsy showed typical acetaminophen-induced necrosis and a microvesicular steatosis in periportal hepatocytes. These injuries might have been favored by pre-existing mitochondrial dysfunction related, for instance, to a deficiency in an enzyme of the mitochondrial β-oxidation pathway, or the respiratory chain. The observation of microvesicular steatosis in the periportal areas suggests an increased vulnerability via pre-existing mitochondrial dysfunction. As the liver status of patients is mostly unknown, the frequency of administration (every six hours) must be respected and the use of pharmaceutical forms allowing to adjust the dose as closely as possible to the child's weight should be promoted. |
| Databáze: | OpenAIRE |
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