(Received 19 May 1990; accepted 7 August 1990)
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The authors describe a case of fatal acetaminophen overdose which occurred in a 16-year-old female. Her serum acetaminophen concentration 11.5 h postingestion was 154 mg/L. Antidotal therapy was unsuccessful, and after 9 days she died. Autopsy findings included centrilobular zonal liver necrosis, acute proximal renal tubular necrosis, and diffuse alveolar pulmonary damage. Her heart was transplanted into a young woman with congenital heart disease. The recipient expired 14 days after the transplant as a result of sepsis complicating bowel ischemia. The transplanted heart showed extensive subendocardial myocyte necrosis related to acetaminophen toxicity and not rejection.
Director, Toxicology Laboratory, and associate professor, Medical College of Virginia, Richmond, VA
Assistant professor, Medical College of Virginia, Richmond, VA
Resident, Medical College of Virginia, Richmond, VA
Stock #: JFS13106J