Fatal Acetaminophen Poisoning with Evidence of Subendocardial Necrosis of the Heart

The authors describe a case of fatal acetaminophen overdose which occurred in a 16-year-old female. Her serum acetaminophen concentration 11.5 h postingestion was 154 mg/L. Antidotal therapy was unsuccessful, and after 9 days she died. Autopsy findings included centrilobular zonal liver necrosis, ac...

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Bibliographic Details
Published in:Journal of forensic sciences 1991-05, Vol.36 (3), p.930-935
Main Authors: Price, LM, Poklis, A, Johnson, DE
Format: Article
Language:English
Subjects:
Acetaminophen - poisoning
Adolescent
Autopsies
Drug Overdose - pathology
Endocardium - pathology
Female
Forensic pathology
Heart Transplantation
Humans
Kidney - pathology
Liver - pathology
Lung - pathology
Myocardium - pathology
Necrosis
Suicide
Toxicology
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Summary:The authors describe a case of fatal acetaminophen overdose which occurred in a 16-year-old female. Her serum acetaminophen concentration 11.5 h postingestion was 154 mg/L. Antidotal therapy was unsuccessful, and after 9 days she died. Autopsy findings included centrilobular zonal liver necrosis, acute proximal renal tubular necrosis, and diffuse alveolar pulmonary damage. Her heart was transplanted into a young woman with congenital heart disease. The recipient expired 14 days after the transplant as a result of sepsis complicating bowel ischemia. The transplanted heart showed extensive subendocardial myocyte necrosis related to acetaminophen toxicity and not rejection.
ISSN:0022-1198
1556-4029
DOI:10.1520/JFS13106J