長期のアセトアミノフェン服用により肝不全を来した症例

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A 33-year-old woman with liver failure associated with the chronic ingestion of excessive dose of acetaminophen (AAF) was presented. For last five years, she had an analgesics containing AAF intermitently because of headache and fret and fume. She continued to take AAF and she frequently took as much as 40 tablets (5300mg AAF) daily. Two days after the last AAF ingestion, she felt abdominal pain and laboratory data revealed severe liver dysfunction. Plasma exchang, glucagoninsulin therapy and administration of glutathione, N-acetylcysteine and cimetidine saved her from liver failure.<BR>Liver biopsy showed fibrosis and bridging suggesting a chronic liver damage. It was suggested that long-term ingestion of AAF brings the decrease of the amount of glutathion and the induction of cytochrome P-450 oxidizing enzymes, which may lead to an excessive groduction of AAF metabolites as the cause of hepatic failure. A special care should be taken for those with chronic AAF intoxication.
社団法人日本肝臓学会の論文