Paracetamol
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Reactions 1454 - 1 Jun 2013 S Paracetamol Encephalopathy, hyperbilirubinaemia, coagulopathy: case report A 37-year-old woman developed encephalopathy, hyperbilirubinaemia and coagulopathy associated with paracetamol [acetaminophen] toxicity. The woman presented with encephalopathy, hyperbilirubinaemia and coagulopathy, and was found to have a toxic paracetamol concentration 48 hours after ingestion [dosage and indication not stated]. Her neurological status deteriorated and she showed signs of impending central herniation, including bilateral Babinski sign, sustained clonus and extensor posturing. The woman was treated in an ICU; hypernatraemia and hypothermia were induced. Her INR was significantly elevated and her liver function tests were deteriorating; she received continuous renal replacement therapy in order to maintain hypernatraemia. She was cooled for 6 days and subsequently underwent rewarming when her neurological status and liver function improved. She was extubated and on hospital day 32 she was discharged; she had made a complete neurologic recovery and her liver function was improving. Author comment: "A 37-year-old female with a past medical history significant for alcohol dependence presented with encephalopathy, coagulopathy and hyperbilirubinaemia and was found to have a toxic acetaminophen level 48 hours after ingestion." Roske J, et al. Severe encephalopathy and impending cerebral herniation in acetaminophen toxicity: Recovery with a novel hypernatremic/hypothermic protocol. Critical Care Medicine 39: 19, Dec 2011. Available from: URL: http:// dx.doi.org/10.1097/01.ccm.0000408627.24229.88 [abstract] - USA 803087618 1 Reactions 1 Jun 2013 No. 1454 0114-9954/10/1454-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
Transcript of Paracetamol
Reactions 1454 - 1 Jun 2013
SParacetamol
Encephalopathy, hyperbilirubinaemia,coagulopathy: case report
A 37-year-old woman developed encephalopathy,hyperbilirubinaemia and coagulopathy associated withparacetamol [acetaminophen] toxicity.
The woman presented with encephalopathy,hyperbilirubinaemia and coagulopathy, and was found to havea toxic paracetamol concentration 48 hours after ingestion[dosage and indication not stated]. Her neurological statusdeteriorated and she showed signs of impending centralherniation, including bilateral Babinski sign, sustained clonusand extensor posturing.
The woman was treated in an ICU; hypernatraemia andhypothermia were induced. Her INR was significantly elevatedand her liver function tests were deteriorating; she receivedcontinuous renal replacement therapy in order to maintainhypernatraemia. She was cooled for 6 days and subsequentlyunderwent rewarming when her neurological status and liverfunction improved. She was extubated and on hospital day 32she was discharged; she had made a complete neurologicrecovery and her liver function was improving.
Author comment: "A 37-year-old female with a pastmedical history significant for alcohol dependence presentedwith encephalopathy, coagulopathy and hyperbilirubinaemiaand was found to have a toxic acetaminophen level 48 hoursafter ingestion."Roske J, et al. Severe encephalopathy and impending cerebral herniation inacetaminophen toxicity: Recovery with a novel hypernatremic/hypothermicprotocol. Critical Care Medicine 39: 19, Dec 2011. Available from: URL: http://dx.doi.org/10.1097/01.ccm.0000408627.24229.88 [abstract] - USA 803087618
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Reactions 1 Jun 2013 No. 14540114-9954/10/1454-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
