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International Journal of Advances In Case Reports

Volume 11, Issue 1, 2024
Mcmed International
International Journal of Advances In Case Reports
Issn
XXX-XXXX (Print), 2349 - 8005 (Online)
Frequency
bi-annual
Email
editorijacr@mcmed.us
Journal Home page
http://mcmed.us/about/ijacr
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Abstract
Title
PEDIATRIC STAGGERED PARACETAMOL OVERDOSE WITH FULMINANT HEPATORENAL SYNDROME AND BILATERAL RENAL CALCULI- MANAGEMENT CHALLENGES
Author
1Govani Dhaval, *2Patel Ramnik, 3Lawther Suzanne, 4Dick Alistair, 5Bailie Alan, 6Marshall David
Email
ramnik@doctors.org.uk
keyword
Adolescent,staggered overdose,Paracetamol,Hepatorenal syndrome, Urinary tract infection, Renal stones, ESWL, Peritoneal dialysis.
Abstract
We report a case of staggered paracetamol overdose secondary to calculation of estimated body weight from a formula rather than the actual body weight in a 12-year-old boy who developed potentially lethal severe fulminant form of hepatorenal shut down. This not only required several days of intensive care treatment but the course was complicated by bilateral renal stones and the liver function was quickly returning back to normal but his renal function was lingering way behind. The possibility of reflux anuria led to further investigations and interventional procedures during his multiple organ failure period. Bilateral staged double J stent insertion followed later by extracorporeal shock wave lithotripsy (ESWL) produced therapeutic effects and complete recovery. Adolescent iatrogenic staggered paracetamol overdose causing secondary potentially lethal hepatorenal syndrome and causing confusion with reflux urolithiasis related anuria is rare. We report the first such rare case presenting as unintentional iatrogenic pharmocotoxicity who responded well to treatment with complete recovery.
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