A 40 year old lady presented to hospital with decreasing conscious level. She was found by her partner with empty paracetamol packaging on the floor. In the Emergency Department, her conscious level continued to deteriorate to GCS 6 (E1V1M4) and she was intubated and ventilated.
Initial investigations showed paracetamol induced hepatotoxicity, but no disturbance in liver synthetic function. Her case was discussed with the regional liver centre and the patient was transferred there for further assessment and management. At the liver centre, she developed fulminant liver failure and subsequently underwent a successful orthotopic liver transplant.
Written by Dr Mohamed Shoaeir
First published 10 February 2022