Paracetamol overdose causing acute kidney injury without hepatotoxicity: a case report.

IF 2 Q2 EMERGENCY MEDICINE International Journal of Emergency Medicine Pub Date : 2024-07-02 DOI:10.1186/s12245-024-00662-w
Micha Saad, Julien Flament
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Abstract

Background: Paracetamol is a widely used analgesic and antipyretic. Paracetamol-induced hepatotoxicity is well known, but nephrotoxicity without hepatotoxicity is rarely seen.

Case presentation: We present a case of acute kidney injury without hepatotoxicity in paracetamol overdose. A 15-year-old girl was admitted 48 h after she had taken 10 g of paracetamol. She was complaining of abdominal pain and vomiting. Her blood level of creatinine was 1.20 mg/dL on admission, with a peak at 3.67 mg/dL 3 days later. The liver blood tests and blood paracetamol level were negative. She did not receive N-acetyl cysteine and was treated with intravenous fluid (crystalloid). The ultrasonography of the kidneys was normal. Her renal function returned almost to baseline 7 days after admission. It was concluded that the diagnosis was an acute kidney injury caused by acute tubular necrosis due to paracetamol overdose.

Conclusion: This case shows that nephrotoxicity can occur without hepatotoxicity in paracetamol overdose.

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对乙酰氨基酚过量导致急性肾损伤而无肝毒性:病例报告。
背景:扑热息痛是一种广泛使用的镇痛药和解热镇痛药。扑热息痛引起的肝毒性已广为人知,但无肝毒性的肾毒性却很少见:我们报告了一例扑热息痛过量引起的急性肾损伤,但无肝毒性。一名 15 岁女孩在服用 10 克扑热息痛 48 小时后入院。她主诉腹痛和呕吐。入院时她的血肌酐水平为 1.20 毫克/分升,3 天后达到峰值 3.67 毫克/分升。肝脏血液化验和血液中扑热息痛水平均为阴性。她没有接受 N-乙酰半胱氨酸治疗,而是接受了静脉输液(晶体液)治疗。肾脏超声波检查结果正常。入院 7 天后,她的肾功能几乎恢复到基线水平。结论:该病例表明,肾毒性是一种常见的肾脏疾病:本病例表明,扑热息痛过量时可能会出现肾毒性,但不会出现肝毒性。
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来源期刊
CiteScore
4.60
自引率
0.00%
发文量
63
审稿时长
13 weeks
期刊介绍: The aim of the journal is to bring to light the various clinical advancements and research developments attained over the world and thus help the specialty forge ahead. It is directed towards physicians and medical personnel undergoing training or working within the field of Emergency Medicine. Medical students who are interested in pursuing a career in Emergency Medicine will also benefit from the journal. This is particularly useful for trainees in countries where the specialty is still in its infancy. Disciplines covered will include interesting clinical cases, the latest evidence-based practice and research developments in Emergency medicine including emergency pediatrics.
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