Combined Hepatic and Renal Injury in Alcoholics During Therapeutic Use of Acetaminophen

George Kaysen, Susan M. Pond, Martha H. Roper, David J. Menke, Mark A. Marrama

Research output: Contribution to journalArticle

46 Scopus citations

Abstract

Combined hepatocellular injury and renal tubular necrosis developed in five alcoholic patients who were receiving acetaminophen therapeutically. Two patients were taking doses prescribed by a physician. The hepatitis was characterized by extremely high serum transaminase values that were maximal on admission. Two patients died, and autopsy disclosed hepatic centrizonal necrosis and acute renal tubular necrosis. The three who survived had clinical features typical of acute tubular necrosis. All five had measurable concentrations of acetaminophen in plasma, although measurements were requested on admission only in two patients. When an alcoholic presents with combined hepatic and renal insufficiency, acetaminophen should be considered as a possible inciting agent. This diagnosis should be considered when serum transaminase levels are markedly elevated and when renal failure is due to acute tubular necrosis.

Original languageEnglish (US)
Pages (from-to)2019-2023
Number of pages5
JournalArchives of Internal Medicine
Volume145
Issue number11
DOIs
StatePublished - 1985
Externally publishedYes

ASJC Scopus subject areas

  • Internal Medicine

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