Unconjugated Hyperbilirubinemia in Acetaminophen-Related Acute Liver Failure

BACKGROUND In the absence of liver transplantation, the natural history of acetaminophen-induced liver failure is characterized by a progressive increase of liver function tests, including bilirubin mainly as its conjugated form. The presence of high levels of unconjugated bilirubin is more unusual;...

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Bibliographic Details
Published in:The American journal of case reports 2024-03, Vol.25, p.e942703-e942703
Main Authors: Philippart, Marie, Mesland, Jean-Baptiste, Haufroid, Vincent, Collienne, Christine, Hantson, Philippe
Format: Article
Language:English
Subjects:
Acetaminophen - adverse effects
Bilirubin
Gilbert Disease - diagnosis
Humans
Hyperbilirubinemia - chemically induced
Hyperbilirubinemia - diagnosis
Liver
Liver Failure, Acute - chemically induced
Liver Failure, Acute - diagnosis
Male
Middle Aged
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Summary:BACKGROUND In the absence of liver transplantation, the natural history of acetaminophen-induced liver failure is characterized by a progressive increase of liver function tests, including bilirubin mainly as its conjugated form. The presence of high levels of unconjugated bilirubin is more unusual; its etiology is unclear and its prognostic factor has been poorly investigated. CASE REPORT A 52-year-old man with a history of chronic analgesics, alcohol, and illicit drug abuse developed acute liver failure in relationship with the ingestion of largely supra-therapeutic doses of acetaminophen over the days preceding admission. The patient received the classical N-acetylcysteine treatment regimen for acetaminophen overdose. Clinical course was characterized by a progressive worsening of the neurological condition, evolving to grade IV encephalopathy. Coagulation disorders persisted, with factor V level
ISSN:1941-5923
1941-5923
DOI:10.12659/AJCR.942703