METABOLISM OF PARACETAMOL IN CHILDREN WITH CHRONIC LIVER-DISEASE

Objective: To study the metabolism of single doses of paracetamol in p aediatric patients with chronic liver disease admitted to a hospital l iver disease clinic. Results: Thirteen paediatric patients, aged 7 mon ths to 12 years, with chronic liver disease of varying severity were s tudied. In these children, paracetamol elimination half-life was negat ively correlated with serum albumin and positively with prothrombin ti me, as previously reported in adults with liver disease. The rate cons tant of glucuronide formation was higher in the children with liver di sease compared to the value reported in healthy children of similar ag es. The rate constant of the formation of paracetamol sulphate was no different from that in normal children. The 36 h urinary paracetamol g lucuronide to sulphate ratio was 1.4 (95% CI 0.8 to 1.7). This mean ra tio was higher than in healthy children(0,81 and 0.75) but not signifi cantly so, probably because of a Type 1 error due to the inevitable sm all sample size arising from the nature of the population being studie d. Conclusion: The present study provides reassuring additional data t o indicate that, at least for single doses, there is no cause for conc ern in the use of paracetamol in children with chronic liver disease.