TREATMENT OF SEVERE ACETAMINOPHEN-INDUCED HEPATOCELLULAR INJURY WITH PROSTAGLANDIN-E - 2 CASE-REPORTS

Drugs have long been recognized as culprits in hepatocellular injury. Acetaminophen is one example of a commonly used over-the-counter medic ation that can cause severe centrolobular hepatic necrosis when ingest ed in large quantities in suicide attempts or unintentional overdoses. Acetaminophen hepatotoxicity is mediated by a toxic reactive metaboli te formed from the parent compound by the cytochrome P450 mixed-functi on oxidase system of the hepatocyte. Conventional treatment of acetami nophen-induced liver injury consists of supportive measures and preven tion of further drug absorption. In addition, in patients with high se rum acetaminophen concentrations, the severity of hepatic necrosis app ears to diminish with the timely use of sulfhydryl compounds such as N -acetyl cysteine. Two patients in whom acetaminophen hepatotoxicity wa s successfully treated using prostaglandin E(1) are described.