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Br Med J. Sep 5, 1970; 3(5722): 557–558.
PMCID: PMC1701561

Acute Paracetamol Poisoning


Of 41 cases of acute paracetamol poisoning one died of gastrointestinal haemorrhage and acute massive necrosis of the liver, three became jaundiced, and 13 others had biochemical evidence of hepatocellular damage. Liver damage is a toxic effect which is present in most patients who ingest more than 15 g. of paracetamol. One patient with liver damage survived renal failure due to acute tubular necrosis. It is suggested that the renal lesion was also the result of paracetamol overdosage.

Profound hypoglycaemia and metabolic acidosis may also complicate severe poisoning. Plasma levels of para-aminophenol fall rapidly, and procedures currently used to enhance the elimination of the drug cannot be expected to prevent development of hepatic damage.

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Selected References

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  • Davidson DG, Eastham WN. Acute liver necrosis following overdose of paracetamol. Br Med J. 1966 Aug 27;2(5512):497–499. [PMC free article] [PubMed]
  • JUDAH JD. Effect of antihistamines on mitochondrial swelling and liver injury. Nature. 1960 Feb 6;185:390–391. [PubMed]
  • Maclean D, Peters TJ, Brown RA, McCathie M, Baines GF, Robertson PG. Treatment of acute paracetamol poisoning. Lancet. 1968 Oct 19;2(7573):849–852. [PubMed]
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  • Thomson JS, Prescott LF. Liver damage and impaired glucose tolerance after paracetamol overdosage. Br Med J. 1966 Aug 27;2(5512):506–507. [PMC free article] [PubMed]
  • Toghill PJ, Williams R, Stephens JD, Carroll JD. Acute hepatic necrosis following an overdose of paracetamol. Gastroenterology. 1969 Apr;56(4):773–776. [PubMed]

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