The hepatoprotective effect of N-acetylcysteine with repeated toxic acetaminophen ingestions: a case report

AbstractWe present a patient who presented 37 times after large acute acetaminophen ingestions without residual signs of liver dysfunction. The presentations were all very similar: witnessed ingestions of 25 g of acetaminophen presenting within 1 h. Due to a potentially toxic serum acetaminophen concentration, she received N-acetylcysteine 16 times within a 12-month period and 21 times overall. This case is an extreme real-life example regarding the absence of subsequent hepatic injury with repeated potentially toxic acetaminophen ingestions requiring repeated treatments with N-acetylcysteine despite a theoretical vulnerable time period immediately after acetaminophen overdose.