Case Report

Acute Liver Failure in Two Patients with Regular Alcohol Consumption Ingesting Paracetamol at Therapeutic Dosage
Stephan Krähenbühl^a, Yolanda Brauchli^a, Oliver Kummer^a, Michael Bodmer^a, Marten Trendelenburg^b, Jürgen Drewe^a, Manuel Haschke<sup>a

a</sup>Division of Clinical Pharmacology and Toxicology and
^bDepartment of Internal Medicine, University Hospital Basel, Basel, Switzerland

Address of Corresponding Author

Digestion 2007;75:232-237 (DOI: 10.1159/000111032)

  Key Words

• Paracetamol
• Acetaminophen, therapeutic dosage
• Liver failure, risk factors
• Alcohol

  Abstract

Background: The possible role of alcohol in the development of hepatotoxicity associated with therapeutic doses of paracetamol (acetaminophen) is currently debated. Case Report: We describe 2 patients who were regular consumers of alcohol and who developed liver failure within 3-5 days after hospitalization and stopping alcohol consumption while being treated with 4 g paracetamol/day. A paracetamol serum level obtained in one of these patients was not in the toxic range. Possible risk factors for the development of hepatotoxicity in patients treated with therapeutic doses of paracetamol are discussed. Conclusion: In patients with risk factors, e.g. regular consumption of alcohol, liver failure is possible when therapeutic doses are ingested. We propose that the paracetamol dose should not exceed 2 g/day in such patients and that their liver function should be monitored closely while being treated with paracetamol.

Copyright © 2007 S. Karger AG, Basel

  Author Contacts

Stephan Krähenbühl, MD, PhD
Clinical Pharmacology and Toxicology, University Hospital
CH-4031 Basel (Switzerland)
Tel. +41 61 265 4715, Fax +41 61 265 4560
E-Mail kraehenbuehl@uhbs.ch

  Article Information

Published online: November 14, 2007
Number of Print Pages : 6
Number of Figures : 1, Number of Tables : 0, Number of References : 41