Concealed paracetamol overdose treated as HELLP syndrome in the presence of postpartum liver dysfunction

Int J Obstet Anesth. 2014 May;23(2):189-93. doi: 10.1016/j.ijoa.2014.01.006. Epub 2014 Feb 5.

Abstract

Paracetamol is the most frequently used analgesic during pregnancy and the most common drug involved in suicidal overdose in the UK. Manifestation of toxicity classically occurs over four phases with clinical and laboratory features resembling HELLP (haemolysis, elevated liver enzymes, low platelets) syndrome. We report a case that was erroneously managed as HELLP syndrome before a paracetamol overdose was diagnosed. This case highlights current practice in managing paracetamol overdose and focuses on the importance of addressing mental health issues to mitigate the risk of self-harm in pregnancy.

Keywords: HELLP syndrome; Liver dysfunction; Paracetamol; Toxicity.

Publication types

  • Case Reports

MeSH terms

  • Acetaminophen / poisoning*
  • Adult
  • Analgesics, Non-Narcotic / poisoning*
  • Cesarean Section
  • Chemical and Drug Induced Liver Injury / therapy*
  • Diagnosis, Differential
  • Drug Overdose / diagnosis*
  • Drug Overdose / therapy*
  • Female
  • HELLP Syndrome / diagnosis*
  • HELLP Syndrome / therapy*
  • Humans
  • Infant, Newborn
  • Postpartum Period
  • Pregnancy

Substances

  • Analgesics, Non-Narcotic
  • Acetaminophen