Skip to main content
PMC home page
Journal of the Royal Society of Medicine logoLink to Journal of the Royal Society of Medicine
. 1980 Oct;73(10):701–707. doi: 10.1177/014107688007301004

Long-term ingestion of paracetamol and liver disease1

James Neuberger, M Davis, Roger Williams
PMCID: PMC1438089  PMID: 7241423

Abstract

Of 45 patients with chronic active hepatitis, 17 had taken paracetamol before the onset of symptoms. There were no significant differences, however, between the two groups in abnormalities of liver function tests, nor in ease of control after paracetamol withdrawal and institution of immunosuppressive therapy. The patient who had taken more than 5 g/week was studied in greater detail, but after a challenge dose of 1 g paracetamol there was no rise in serum aminotransferases and the pattern of excretion of paracetamol metabolites was normal. A critical review of the previously published reports failed to uncover any convincing evidence that paracetamol is an initiating factor in the development of chronic active hepatitis, although it may, at therapeutic levels, cause a toxic hepatitis in those individuals at risk.

Full text

PDF
701

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Athreya B. H., Moser G., Cecil H. S., Myers A. R. Aspirin-induced hepatotoxicity in juvenile rheumatoid arthritis. A prospective study. Arthritis Rheum. 1975 Jul-Aug;18(4):347–352. doi: 10.1002/art.1780180409. [DOI] [PubMed] [Google Scholar]
  2. Barker J. D., Jr, de Carle D. J., Anuras S. Chronic excessive acetaminophen use and liver damage. Ann Intern Med. 1977 Sep;87(3):299–301. doi: 10.7326/0003-4819-87-3-299. [DOI] [PubMed] [Google Scholar]
  3. Bonkowsky H. L., Mudge G. H., McMurtry R. J. Chronic hepatic inflammation and fibrosis due to low doses of paracetamol. Lancet. 1978 May 13;1(8072):1016–1018. doi: 10.1016/s0140-6736(78)90740-7. [DOI] [PubMed] [Google Scholar]
  4. Davis M., Simmons C. J., Harrison N. G., Williams R. Paracetamol overdose in man: relationship between pattern of urinary metabolites and severity of liver damage. Q J Med. 1976 Apr;45(178):181–191. [PubMed] [Google Scholar]
  5. Dykes M. H. Is halothane hepatitis chronic active hepatitis? Anesthesiology. 1977 Apr;46(4):233–235. doi: 10.1097/00000542-197704000-00001. [DOI] [PubMed] [Google Scholar]
  6. Eisner E. V., Shahidi N. T. Immune thrombocytopenia due to a drug metabolite. N Engl J Med. 1972 Aug 24;287(8):376–381. doi: 10.1056/NEJM197208242870803. [DOI] [PubMed] [Google Scholar]
  7. Forrest J. A., Adriaenssens P., Finlayson N. D., Prescott L. F. Paracetamol metabolism in chronic liver disease. Eur J Clin Pharmacol. 1979 Jul;15(6):427–431. doi: 10.1007/BF00561743. [DOI] [PubMed] [Google Scholar]
  8. Gazzard B. G., Widdop B., Davis M., Hughes R. D., Goulding R., Williams R. Early prediction of the outcome of a paracetamol overdose based on an analysis of 163 patients. Postgrad Med J. 1977 May;53(619):243–247. doi: 10.1136/pgmj.53.619.243. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Johnson G. K., Tolman K. G. Chronic liver disease and acetaminophen. Ann Intern Med. 1977 Sep;87(3):302–304. doi: 10.7326/0003-4819-87-3-302. [DOI] [PubMed] [Google Scholar]
  10. Leaf G., Neuberger A. The effect of diet on the glutathione content of the liver. Biochem J. 1947;41(2):280–287. [PMC free article] [PubMed] [Google Scholar]
  11. Mitchell J. R., Jollow D. J., Potter W. Z., Gillette J. R., Brodie B. B. Acetaminophen-induced hepatic necrosis. IV. Protective role of glutathione. J Pharmacol Exp Ther. 1973 Oct;187(1):211–217. [PubMed] [Google Scholar]
  12. Rau R., Weber S., Böni A. Allergisch-toxische Leberschädigung durch D-Penizillamin. Schweiz Med Wochenschr. 1972 Aug 26;102(34):1226–1228. [PubMed] [Google Scholar]
  13. Reynolds T. B., Peters R. L., Yamada S. Chronic active and lupoid hepatitis caused by a laxative, oxyphenisatin. N Engl J Med. 1971 Oct 7;285(15):813–820. doi: 10.1056/NEJM197110072851501. [DOI] [PubMed] [Google Scholar]
  14. Rosenberg D. M., Meyer A. A., Manning I. H., Jr, Neelon F. A. Acetaminophen and hepatic dysfunction in infectious mononucleosis. South Med J. 1977 Jun;70(6):660–661. doi: 10.1097/00007611-197706000-00007. [DOI] [PubMed] [Google Scholar]
  15. Sacher M., Thaler H. Toxic hepatitis after therapeutic doses of benorylate and D-penicillamine. Lancet. 1977 Feb 26;1(8009):481–482. doi: 10.1016/s0140-6736(77)91965-1. [DOI] [PubMed] [Google Scholar]
  16. Teschke R., Stutz G., Strohmeyer G. Increased paracetamol-induced hepatotoxicity after chronic alcohol consumption. Biochem Biophys Res Commun. 1979 Nov 14;91(1):368–374. doi: 10.1016/0006-291x(79)90628-4. [DOI] [PubMed] [Google Scholar]
  17. Vergani D., Mieli-Vergani G., Alberti A., Neuberger J., Eddleston A. L., Davis M., Williams R. Antibodies to the surface of halothane-altered rabbit hepatocytes in patients with severe halothane-associated hepatitis. N Engl J Med. 1980 Jul 10;303(2):66–71. doi: 10.1056/NEJM198007103030202. [DOI] [PubMed] [Google Scholar]

Articles from Journal of the Royal Society of Medicine are provided here courtesy of Royal Society of Medicine Press

RESOURCES