Severe hepanonephritis and buprenorphine intoxication

We present a case of a severe hepatitis associated with acute renal failure and anuria consequently to the ingestion of 112 mg of buprenorphine, 48 ho urs before. The normalisation of hepatic and renal functions is associated with discontinuation of buprenorphine administration and hemodialysis treat ment. Buprenorphine seems to be directly responsible for this hepatonephrit is as indicated by the high plasmatic levels of buprenorphine (224 ng/ml) a nd norbuprenorphine (30 ng/ml) never described until now. Buprenorphine tox icity could be due to the inappropriate ingestion mode (oral instead of sub lingual) and could be increased by previous acetaminophen intake.