Acute Renal Failure and Hemolytic Uremic Syndrome in Overdose With N-acetyl Cysteine After Acetaminophen Poisoning

Q4 Medicine

Nephro-urology Monthly Pub Date : 2021-12-31 DOI:10.5812/numonthly.114074

R. Asadzadeh, Z. Khalighi, Nahid Mamizadeh, M. Hadavi, A. Ghaysouri, A. Mozafari

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引用次数: 2

Abstract

Context: Acetylcysteine is an effective treatment for acetaminophen poisoning. The preparation and dose calculation of acetylcysteine is associated with medical errors. The prevalence of this error is 84.3% globally. Case report: A 15-year-old girl took an overdose of acetaminophen in a suicide attempt. Acetylcysteine intravenous was ordered. Due to the medication error by the nurse, she received a 10-fold overdose of intravenous acetylcysteine in both initial loading dose and maintenance dose. On the second day, the patient showed abdominal pain, nausea, vomiting, and elevated liver enzymes. Her hemoglobin, hematocrit, and platelet quickly decreased. Subsequently, she developed oliguria, anuria, and rising serum creatinine levels. The patient was diagnosed with uremic hemolytic syndrome. She underwent hemodialysis and was treated with plasmapheresis, blood transfusions, and platelets. Discussion: The effects of acetaminophen poisoning and acetylcysteine overdose may be much more severe and have a greater impact on patient survival. Timely and accurate treatment measures can help prevent long-term side effects.

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对乙酰氨基酚中毒后过量服用N-乙酰半胱氨酸引起的急性肾功能衰竭和溶血性尿毒症综合征

背景:乙酰半胱氨酸是治疗对乙酰氨基酚中毒的有效药物。乙酰半胱氨酸的制备和剂量计算与医疗差错有关。在全球范围内，这种误差的发生率为84.3%。病例报告:一名15岁的女孩在自杀企图中服用过量的对乙酰氨基酚。嘱静脉注射乙酰半胱氨酸。由于护士用药错误，患者接受了初始负荷剂量和维持剂量均超过10倍的乙酰半胱氨酸静脉注射。第2天，患者出现腹痛、恶心、呕吐、肝酶升高。她的血红蛋白、红细胞压积和血小板迅速下降。随后，患者出现少尿、无尿和血清肌酐水平升高。患者被诊断为尿毒症溶血综合征。她接受了血液透析，并接受了血浆置换、输血和血小板治疗。讨论:对乙酰氨基酚中毒和乙酰半胱氨酸过量的影响可能更严重，对患者的生存有更大的影响。及时准确的治疗措施有助于预防长期的副作用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Nephro-urology Monthly Medicine-Urology

CiteScore

0.40

自引率

0.00%

发文量