An autopsy case of acute hepatic failure caused by ingesting a small dose of acetaminophen in a drinker

Abstract

We have experienced an autopsy case of acute hepatic failure caused by ingesting of a single dose (4.8gr.) of acetaminophen for the purpose of suiside. A forty-year-old-woman was admitted to our hospital in comatic condition. Her clinical course and laboratory data were those of acute hepatic failure. She died 7 days after admission in spite of the therapy of plasma exchange. At autopsy, the liver was markedly atrophic and its weight was 750 gr. Microscopically, a massive liver cell necrosis was noted. It is well known that overdose of acetaminophen induces acute liver injury. However, in this case, the dose of acetaminophen was relatively low (4.8 gr.). Concerning the cause of the marked liver injury by acetaminophen, following factors may be related; 1) the patient had been a drinker 2) acetaminophen was taken together with alcohol and caffein contained in Sedes A. These factors might enhanced acetaminophen-induced hepatotoxicity. © 1989, The Japan Society of Hepatology. All rights reserved.