ACUTE LIVER-FAILURE FOLLOWING ACETAMINOPH EN INGESTION - IS PROTRACTED N-ACETYLCYSTEINE ADMINISTRATION USEFUL

Background. - Some cases of paracetamol-induced acute hepatic failure may require liver transplantation but the present shortage of graft ur ges the search for an alternate therapeutic approach. Case report. - A 17 year-old girl was admitted for sleepingness and vomiting after abo ut 15 hours of voluntary brit denied absorption of paracetamol. Plasma paracetamol concentration was 120 mg/l; factors VII + X level were 55 % and factor V 106%. The patient was given IV N-acetylcysteine, 150 mg /kg/30 min, then 50 mg/kg/4 hours. Further decrease in facteur VII lev el led to pursue administration of N-acetylcysteine (total dose: 350 m g/kg/2 hours). While indication of liver transplantation was considere d, clinical and laboratory findings definitely improved Conclusions. - N-acetylcysteine may be effective even if administered late. Repeated determination of factor VII could be a goad means for managing such a severe condition.