Fulminant hepatorenal syndrome due to Acetaminophen toxicity: A case report

Nekoukar, Zahra; Moghimi, Minoo; Zakariaei, Zakaria; Fakhar, Mahdi; Tabaripour, Rabeeh

doi:10.1002/ccr3.4037

Cited by 3 publications

(2 citation statements)

References 16 publications

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“…Our patient had one risk factor that can increase nephrotoxicity by acetaminophen, type 2 diabetes. The treatment is generally supportive, to avoid further kidney injury 15 and includes supportive care with monitoring of renal function and hemodialysis in cases with worsening glomerular filtration 18 .…”

Section: Discussionmentioning

confidence: 99%

“…Studies have shown that N-acetylcysteine can protect against hepatotoxicity but is ineffective for preventing nephrotoxicity 2 . N-acetylcysteine is effective against the replenishing glutathione stores caused by oxidative metabolite of acetaminophen and could prevent or reduce the severity of acetaminophen hepatotoxicity 18 . The literature supports hemodialysis for acetaminophen overdose with signs of severe toxicity, including central nervous system depression.…”

Section: Discussionmentioning

confidence: 99%

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Nephrotoxicity by overdose of acetaminophen

GJERMENI¹,

NELAJ²,

KECAJ³

et al. 2021

Arch Balk Med Union

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Néphrotoxicité par surdosage d'acétaminophèneIntroduction. L'acétaminophène (paracétamol) est un médicament largement utilisé et connu comme un analgésique et antipyrétique sûrs. L'hépatotoxicité est généralement la première complication d'une surdose d'acétaminophène. La néphrotoxicité apparaît généralement après une toxicité hépatique. La plupart des études sur ce sujet se sont concentrées sur des cas de surdosage aigu d'acétaminophène, avec moins d'études sur les effets d'un surdosage chronique. Présentation du cas. Nous présentons le cas d'une femme de 74 ans souffrant d'insuffisance rénale aiguë à cause d'un surdosage chronique d'acétaminophène et une mini revue de la littérature. Le patient s'est présenté aux urgences pour confusion, avec altération des paramètres vitaux. Elle avait utilisé régulièrement 5 à 6 g/jour de paracétamol au cours des 4 semaines précédentes en raison de douleurs articulaires. Une insuffisance rénale et hépatique aiguë a été diagnostiquée. Après un traitement spécifique, le patient est sorti en bon état. Conclusions. Un historique approprié des médicaments administrés (y compris aussi ceux sans ordonnance du médecin) permet un diagnostic précis et permet une prise en charge thérapeutique plus rapide.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Nephrotoxicity by overdose of acetaminophen

GJERMENI¹,

NELAJ²,

KECAJ³

et al. 2021

Arch Balk Med Union

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Multiple drugs

2021

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Preventive Effects of Mandarin Fruit Peel Hydroethanolic Extract, Hesperidin, and Quercetin on Acetaminophen-Induced Hepatonephrotoxicity in Wistar Rats

Eldin

Fahim

Ahmed

et al. 2022

Oxidative Medicine and Cellular Longevity

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Acetaminophen, also known as N-acetyl-para-aminophenol (NAPAP), is a traditional antipyretic and analgesic that is used extensively around the world to treat colds and fevers. However, a NAPAP excess causes rapid, severe liver and kidney damage. The goal of the study was to examine the protective effects and determine the mechanisms of action of MPHE, hesperidin, and quercetin in NAPAP-induced hepatorenal damage in Wistar rats. Male Wistar rats received a 0.5 g/kg oral supplement of NAPAP every other day for a period of four weeks. During the same period of NAPAP supplementation, MPHE (50 mg/kg), quercetin (20 mg/kg), and hesperidin (20 mg/kg) were administered to rats receiving NAPAP. MPHE, quercetin, and hesperidin treatments significantly improved liver function in NAPAP-supplemented rats. The high serum levels of aminotransferases, alkaline phosphatase, lactate dehydrogenase, and γ-glutamyl transferase as well as total bilirubin were significantly reduced, while the levels of suppressed serum albumin were significantly increased, demonstrating this improvement. Treatments utilizing these natural substances significantly enhanced kidney function as seen by a considerable decline in the increased blood levels of urea, uric acid, and creatinine. Additionally, the injection of MPHE, hesperidin, and quercetin resulted in a decrease in the quantity of lipid peroxides while increasing the activities of superoxide dismutase, glutathione peroxidase, and glutathione-S-transferase in the liver and kidneys. The treatments markedly abated the NAPAP-induced liver and kidney histological perturbations and reduced the NAPAP-induced serum tumor necrosis factor-α level and liver and kidney proapoptotic protein 53 and caspase 3 expressions. Otherwise, serum interleukin-4 level significantly increased by treatments. The MPHE, hesperidin, and quercetin treatments resulted in marked decrease in liver and kidney histopathological scores including inflammation, necrosis, apoptosis, and congestion. In conclusion, the MPHE, quercetin, and hesperidin may induce hepatonephropreventive impacts in NAPAP-supplemented rats via enhancing the antioxidant defense system, anti-inflammatory activity, and antiapoptotic action.

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Fulminant hepatorenal syndrome due to Acetaminophen toxicity: A case report

Abstract: HRS is a rare and poor prognosis complication of chronic acetaminophen toxicity, which presents by progressive decline in renal function secondary to liver failure.

Cited by 3 publications

References 16 publications

Nephrotoxicity by overdose of acetaminophen

Nephrotoxicity by overdose of acetaminophen

Multiple drugs

Preventive Effects of Mandarin Fruit Peel Hydroethanolic Extract, Hesperidin, and Quercetin on Acetaminophen-Induced Hepatonephrotoxicity in Wistar Rats

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