Acute tubular injury in a patient with acetaminophen toxicity

Authors

Zhe Ran S. Duan, Department of Pathology and Cell Biology, Columbia University Irving Medical Center, New York, New York, USA
Umesh Dalal, St. Luke’s University Health Network, Department of Nephrology, Bartonville, Pennsylvania, USA
Vivette D’Agati, Department of Pathology and Cell Biology, Columbia University Irving Medical Center, New York, New York, USA
Satoru Kudose, Department of Pathology and Cell Biology, Columbia University Irving Medical Center, New York, New York, USA

Document Type

Article

Abstract

A 31-year-old woman with a history of alcohol abuse presented with nonoliguric acute kidney injury, mild pancreatitis, and diarrhea. Her only medication was acetaminophen, 1 to 2 g every 4 to 6 hours for 4 days for abdominal pain. Admission blood pressure was 122/74 mm Hg with serum creatinine of 9.16 mg/dl (baseline, 0.5 mg/dl), requiring dialysis. Urine sediment was inactive. Blood ethanol was undetectable. Aspartate and alanine transaminases were >20,000 U/L and 3799 U/L, respectively. Creatine kinase level was normal. Acetaminophen level was 12 μg/ml (therapeutic range, 10–20 μg/ml). Computed tomography showed hepatomegaly and steatosis without cirrhosis or ascites.

DOI

10.1016/j.kint.2023.04.012

Publication Date

Fall 9-1-2023

Recommended Citation

Duan ZR, Dalal U, D’Agati V, Kudose S. Acute tubular injury in a patient with acetaminophen toxicity. Kidney International. 2023 Sep 1;104(3):623.