METHODS: We present a case of acute kidney injury without hepatotoxicity in paracetamol overdose. A 15-year-old girl was admitted 48 h after she had taken 10 g of paracetamol. She was complaining of abdominal pain and vomiting. Her blood level of creatinine was 1.20 mg/dL on admission, with a peak at 3.67 mg/dL 3 days later. The liver blood tests and blood paracetamol level were negative. She did not receive N-acetyl cysteine and was treated with intravenous fluid (crystalloid). The ultrasonography of the kidneys was normal. Her renal function returned almost to baseline 7 days after admission. It was concluded that the diagnosis was an acute kidney injury caused by acute tubular necrosis due to paracetamol overdose.
CONCLUSIONS: This case shows that nephrotoxicity can occur without hepatotoxicity in paracetamol overdose.
方法:我们介绍一例对乙酰氨基酚过量导致急性肾损伤而无肝毒性的病例。一名15岁女孩在服用10克扑热息痛48小时后入院。她抱怨腹痛和呕吐。入院时她的血肌酐水平为1.20mg/dL,3天后达到3.67mg/dL的峰值。肝脏血液检查和血液对乙酰氨基酚水平均为阴性。她没有接受N-乙酰半胱氨酸,并接受了静脉输液(晶体)治疗。肾脏超声检查正常。入院后7天,她的肾功能几乎恢复到基线。结论诊断为扑热息痛过量致急性肾小管坏死所致急性肾损伤。
结论:该病例显示对乙酰氨基酚过量可发生肾毒性而无肝毒性。