{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T10:13:13Z","timestamp":1791972793447,"version":"4.3.4"},"reference-count":13,"publisher":"BMJ","issue":"11","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2022,11,11]]},"published-print":{"date-parts":[[2022,11]]},"abstract":"<jats:p>A woman in her mid-60s, without known liver disease, was admitted to the hospital with a partial malignant colonic obstruction. Over a 6-day course, she received a total of 13 g of intravenous acetaminophen not exceeding 4\u2009g over a 24-hour period. She developed encephalopathy and an international normalised ratio of 6.1 meeting criteria for acute liver failure (ALF). She was treated with intravenous N-acetyl cysteine and other causes of liver failure were excluded. The patient was discharged with subsequent resolution of encephalopathy and improvement of her liver chemistries. Though ALF is rare, in countries where acetaminophen is readily available, almost 50% of ALF cases are acetaminophen-induced hepatotoxicity and most have been documented as oral ingestion of acetaminophen. We present a rare case of intravenous acetaminophen-induced ALF.<\/jats:p>","DOI":"10.1136\/bcr-2022-251305","type":"journal-article","created":{"date-parts":[[2022,11,22]],"date-time":"2022-11-22T10:41:19Z","timestamp":1669113679000},"page":"e251305","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Intravenous acetaminophen associated with acute liver failure"],"prefix":"10.1136","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7144-670X","authenticated-orcid":false,"given":"Maunoo","family":"Lee","sequence":"first","affiliation":[{"name":"Department of Gastroenterology, Naval Medical Center San Diego, San Diego, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua","family":"McCarron","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, 99th Medical Group Mike O'Callaghan Military Medical Center, Nellis AFB, Nevada, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aaron","family":"Balinski","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Naval Medical Center Portsmouth, Portsmouth, Virginia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Bower","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Naval Medical Center San Diego, San Diego, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2022,11,22]]},"reference":[{"key":"2025082703553866000_15.11.e251305.1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.25551"},{"key":"2025082703553866000_15.11.e251305.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.mayocp.2013.09.016"},{"key":"2025082703553866000_15.11.e251305.3","doi-asserted-by":"publisher","DOI":"10.1002\/hep.20948"},{"key":"2025082703553866000_15.11.e251305.4","doi-asserted-by":"publisher","DOI":"10.1007\/s00204-014-1432-2"},{"key":"2025082703553866000_15.11.e251305.5","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2007.01388.x"},{"key":"2025082703553866000_15.11.e251305.6","doi-asserted-by":"publisher","DOI":"10.3949\/ccjm.77a.09084"},{"key":"2025082703553866000_15.11.e251305.7","doi-asserted-by":"crossref","DOI":"10.5812\/hepatmon.23539","article-title":"The therapeutic use of analgesics in patients with liver cirrhosis: a literature review and evidence-based recommendations","volume":"14","author":"Imani","year":"2014","journal-title":"Hepat Mon"},{"key":"2025082703553866000_15.11.e251305.8","doi-asserted-by":"crossref","first-page":"238","DOI":"10.4212\/cjhp.v68i3.1458","article-title":"Intravenous versus oral acetaminophen for pain: systematic review of current evidence to support clinical decision-making","volume":"68","author":"Jibril","year":"2015","journal-title":"Can J Hosp Pharm"},{"key":"2025082703553866000_15.11.e251305.9","first-page":"123","article-title":"Possible hepatotoxicity associated with intravenous acetaminophen in a 36-year-old female patient","volume":"40","author":"Lee","year":"2015","journal-title":"P T"},{"key":"2025082703553866000_15.11.e251305.10","unstructured":"Propofol. LiverTox: Clinical and Research Information on Drug-Induced Liver Injury [Internet], 2020. Available: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK547909\/ [Accessed 1 Aug 2021]."},{"key":"2025082703553866000_15.11.e251305.11","doi-asserted-by":"crossref","first-page":"1841","DOI":"10.1111\/j.1526-4637.2010.00991.x","article-title":"Safety of multiple-dose intravenous acetaminophen in adult inpatients","volume":"11","author":"Candiotti","year":"2010","journal-title":"Pain Med"},{"key":"2025082703553866000_15.11.e251305.12","doi-asserted-by":"crossref","first-page":"e528","DOI":"10.1097\/MJT.0000000000000829","article-title":"Severe acute liver injury following therapeutic doses of acetaminophen in a patient with spinal muscular atrophy","volume":"26","author":"Brehm","year":"2019","journal-title":"Am J Ther"},{"key":"2025082703553866000_15.11.e251305.13","doi-asserted-by":"publisher","DOI":"10.2165\/11537240-000000000-00000"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2022-251305","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T10:55:49Z","timestamp":1756292149000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2022-251305"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,11]]},"references-count":13,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2022,11,22]]},"published-print":{"date-parts":[[2022,11]]}},"alternative-id":["10.1136\/bcr-2022-251305"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2022-251305","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,11]]}}}