RT Book, Section
A1 Choi, H. Alex
A1 Bauer, Rebecca
A1 Lee, Kiwon
A2 Lee, Kiwon
SR Print(0)
ID 1101643047
T1 Fulminant Hepatic Failure
T2 The NeuroICU Book
YR 2012
FD 2012
PB McGraw-Hill Education
PP New York, NY
SN 9780071636353
LK neurology.mhmedical.com/content.aspx?aid=1101643047
RD 2024/04/25
AB A  42-year-old  man  with  no  past  medical  history  presents  with  a  1-week  history  of  sinus  congestion.  He  was  not  getting  adequate  pain  relief  and  took  a  total  of  40  pills  over  24  to  36  hours.  The  next  day  he  developed  right  upper  quadrant  pain,  nausea,  and  vomiting.  He  presented  to  the  hospital  for  these  symptoms.  Examination  is  significant  for  jaundice  and  right  upper  quadrant  abdominal  pain  but  otherwise  unremarkable.  Labs  are  significant  for  aspartate  aminotransferase/alanine  aminotransferase  (AST/ALT)  6180  U/L  and  4860  U/L,  respectively,  total  bilirubin  7.7  mg/dL,  and  International  Normalized  Ratio  (INR)  4.  Acetaminophen  level  was  108  μg/mL.  He  is  started  on  an  N-acetylcysteine  drip  and  transferred  to  the  neurologic  intensive  care  unit  (NICU)  for  close  observation.