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
(Received 19 May 1990; accepted 7 August 1990)
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.
Paper ID: JFS13106J