Hemolysis after acetaminophen overdose in a patient with glucose-6-phosphate dehydrogenase deficiency

Journal of Toxicology. Clinical Toxicology
R O WrightM W Shannon

Abstract

A sixteen year-old-male with a history of glucose-6-phosphate dehydrogenase deficiency ingested an unknown amount of acetaminophen and presented to an emergency department 7.5 h later. He was afebrile. His serum acetaminophen level was 184 micrograms/mL, and his urine toxicologic screen was otherwise negative. Vomiting led to enrollment in a experimental protocol of intravenous N-acetylcysteine. He developed no evidence of subsequent chemical hepatitis but did develop a significant Coomb's negative hemolytic anemia. Hemoglobin on presentation was 14 g/dL and reached a nadir of 9.4 g/dL on admission day 4. Patients with glucose-6-phosphate dehydrogenase deficiency who overdose with acetaminophen should be monitored for the possible development of subsequent drug-induced hemolysis.

References

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Citations

Oct 6, 2011·Clinical Toxicology : the Official Journal of the American Academy of Clinical Toxicology and European Association of Poisons Centres and Clinical Toxicologists·Michael E Mullins, Irena V Vitkovitsky
Apr 2, 2014·European Journal of Haematology·Simon PhillpottsSambit Sen
Aug 13, 2010·Drug Safety : an International Journal of Medical Toxicology and Drug Experience·Ilan YoungsterMatitiahu Berkovitch
Jul 11, 2001·Drug Safety : an International Journal of Medical Toxicology and Drug Experience·E Kozer, G Koren
May 3, 2005·Toxicological Reviews·Marco L A Sivilotti
Dec 2, 2008·Clinical Chemistry·Nichole L Korpi-SteinerAmy K Saenger

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