Acetaminophen Poisoning

To the Editor: Heard (July 17 issue) 1 reports that acetylcysteine reduces the severity of acetaminophen poisoning–induced liver damage by restoring the hepatic glutathione pool. However, one major concern not mentioned in the article is the possible decrease in the prothrombin index (defined in the...

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Bibliographic Details
Published inThe New England journal of medicine Vol. 359; no. 18; pp. 1962 - 1965
Main Authors Mégarbane, Bruno, Deye, Nicolas, Baud, Frédéric J
Format Journal Article
LanguageEnglish
Published United States Massachusetts Medical Society 30.10.2008
Subjects
Acetaminophen - poisoning
Acetylcysteine - therapeutic use
Anti-Inflammatory Agents, Non-Steroidal - poisoning
Cardiology and cardiovascular system
Emerging diseases
Free Radical Scavengers - therapeutic use
Human health and pathology
Humans
Infectious diseases
Life Sciences
Liver - drug effects
Poisoning - drug therapy
Prothrombin Time
Pulmonology and respiratory tract
Toxicology
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Summary:To the Editor: Heard (July 17 issue) 1 reports that acetylcysteine reduces the severity of acetaminophen poisoning–induced liver damage by restoring the hepatic glutathione pool. However, one major concern not mentioned in the article is the possible decrease in the prothrombin index (defined in the legend to Figure 1), a prognostic indicator of hepatotoxicity. Acetylcysteine may significantly reduce the prothrombin index in the absence of liver or clotting abnormalities. 2 , 3 In an 8-year retrospective analysis, we treated 171 patients who had acetaminophen poisoning with intravenous acetylcysteine according to the recommendations outlined in Heard's article. Among 115 patients without underlying or acute . . .
ISSN:0028-4793
1533-4406
DOI:10.1056/NEJMc081715