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  • Title: Hemolysis after acetaminophen overdose in a patient with glucose-6-phosphate dehydrogenase deficiency.
    Author: Wright RO, Perry HE, Woolf AD, Shannon MW.
    Journal: J Toxicol Clin Toxicol; 1996; 34(6):731-4. PubMed ID: 8941205.
    Abstract:
    CASE REPORT: A sixteen year-old-male with a history of glucose-6-phosphate dehydrogenase deficiency ingested an unknown amount of acetaminophen and presented to an emergency department 7.5 h later. He was afebrile. His serum acetaminophen level was 184 micrograms/mL, and his urine toxicologic screen was otherwise negative. Vomiting led to enrollment in a experimental protocol of intravenous N-acetylcysteine. He developed no evidence of subsequent chemical hepatitis but did develop a significant Coomb's negative hemolytic anemia. Hemoglobin on presentation was 14 g/dL and reached a nadir of 9.4 g/dL on admission day 4. CONCLUSION: Patients with glucose-6-phosphate dehydrogenase deficiency who overdose with acetaminophen should be monitored for the possible development of subsequent drug-induced hemolysis.
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