medalphabetМедицинский алфавитMedical alphabet2078-56312949-2807ООО «Альфмед»10.33667/2078-5631-2023-18-28-33medalphabet-3291Research ArticleСтатьиСлучай тяжелого поражения печени у ребенка 12 лет при намеренной передозировке парацетамолаCase of severe liver damage in 12‑year‑old child with intentional overdose of paracetamolhttps://orcid.org/0000-0001-8468-6959ПостниковС. С.PostnikovS. S.

Постников Сергей Сергеевич, кафедра клинической фармакологии лечебного факультета

Москва

Postnikov Sergey S., Dept of Clinical Pharmacology of Faculty of Medicine

Moscow

elixin@list.ruhttps://orcid.org/0000-0003-4259-0945ТепловаН. В.TeplovaN. V.

Теплова Наталья Вадимовна, доктор медицинских наук, профессор, доцент, заведующий кафедрой клинической фармакологии лечебного факультета

Москва 

Teplova Natalya V., DM Sci (habil.), professor, associate professor, head of Dept of Clinical Pharmacology of Faculty of Medicine

Moscow

БрюсовГ. П.BrusovG. P.

Брюсов Глеб Павлович, ОСП «Российская детская клиническая больница»

Москва

Bryusov Gleb P., Russian Children's Clinical Hospital

Moscow

КомароваТ. Н.KomarovaT. N.

Комарова Татьяна Николаевна, ОСП «Российская детская клиническая больница»

Москва

Komarova Tatyana N., Russian Children’s Clinical Hospital

Moscow

РумянцевА. Г.RumyantsevA. G.

ОСП «Российская детская клиническая больница»

Москва

 

Russian Children's Clinical Hospital

Moscow

ТатароваИ. Н.TatarovaI. N.

ОСП «Российская детская клиническая больница»

Москва

Russian Children’s Clinical Hospital

Moscow

ДонюшЕ. К.DonushE. K.

ОСП «Российская детская клиническая больница»

Москва

Russian Children’s Clinical Hospital

Moscow

ЦимбаловаЕ. А.TsimbalovaE. A.

ОСП «Российская детская клиническая больница»

Москва

Russian Children’s Clinical Hospital

Moscow

https://orcid.org/0000-0002-7656-1539КостылеваМ. Н.KostylevaM. N.

Костылева Мария Николаевна, кафедра клинической фармакологии лечебного факультета, ОСП «Российская детская клиническая больница»

Москва

Dept of Clinical Pharmacology, Faculty of Medicine, Russian Children’s Clinical Hospital

Moscow

kostyleva_m_n@rdkb.ruГрацианскаяА. Н.GratsianskayaA. N.

Грацианская Анна Николаевна, кафедра клинической фармакологии лечебного факультета

Москва

Gratsianskaya Anna N., Dept of Clinical Pharmacology, Faculty of Medicine

Moscow

annagrats@rambler.ruЛибцисР. В.LibcisR. V.

Либцис Роман Витальевич, врач стоматолог-хирург

Москва

Libtsis Roman V., dentist-surgeon

Moscow

Romanini@inbox.ruФГАОУ ВО «Российский национальный исследовательский медицинский университет имени Н. И. Пирогова» Минздрава РоссииРоссияRussian National Research Medical University n.a. N. I. PirogovRussian FederationООО «Французский медицинский центр»РоссияFrench Dental ClinicRussian Federation202328102023018Обозрение (2)2833Copyright © Постников С.С., Теплова Н.В., Брюсов Г.П., Комарова Т.Н., Румянцев А.Г., Татарова И.Н., Донюш Е.К., Цимбалова Е.А., Костылева М.Н., Грацианская А.Н., Либцис Р.В., 20232023Постников С.С., Теплова Н.В., Брюсов Г.П., Комарова Т.Н., Румянцев А.Г., Татарова И.Н., Донюш Е.К., Цимбалова Е.А., Костылева М.Н., Грацианская А.Н., Либцис Р.В.Postnikov S.S., Teplova N.V., Brusov G.P., Komarova T.N., Rumyantsev A.G., Tatarova I.N., Donush E.K., Tsimbalova E.A., Kostyleva M.N., Gratsianskaya A.N., Libcis R.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-alphabet.com/jour/article/view/3291

В настоящее время известно более 1200 лекарственных средств почти всех фармакологических классов, способных вызывать лекарственные поражения печени (ЛПП). Антибактериальные средства являются причиной почти половины (45 %) всех ЛПП. На втором месте находятся психотропные средства и анальгетики-антипиретики. И если ЛПП, обусловленные антимикробными препаратами, являются непреднамеренными и обычно – следствие недооценки врачами лекарственной патологии, то поражение печени, возникающее после приема психотропных средств или анальгетиков-антипиретиков, среди которых выделяется парацетамол, нередко является результатом их преднамеренного использования с суицидной целью на фоне депрессии как у взрослых, так и у подростков 12–17 лет.

Currently, more than 1200 drugs of almost all pharmacological classes are known that can cause drug-induced liver injury (DILI). Antibacterial agents are responsible for almost half (45 %) of all DILI. In second place are psychotropic drugs and analgesics-antipyretics. And if DILI caused by antimicrobial drugs are unintentional and usually the result of an underestimation of drug pathology by doctors, then liver damage that occurs after taking psychotropic drugs or antipyretic analgesics, among which paracetamol stands out, is often the result of their deliberate use for suicidal purposes against the background of depression both in adults and in adolescents 12–17 years of age.

лекарственные болезни печенипарацетамолдепрессияотравление лекарствамиdrug-induced liver diseaseparacetamoldepressiondrug poisoningReferencesBunchorntavakul C, Reddy KR. Acetaminophen-related hepatotoxicity. Clin Liver Dis. 2013; 17 (4): 587–viii. DOI: 10.1016/j.cld.2013.07.005.Bunchorntavakul C, Reddy KR. Acetaminophen-related hepatotoxicity. Clin Liver Dis. 2013; 17 (4): 587–viii. DOI: 10.1016/j.cld.2013.07.005.McGill MR, Jaeschke H. Metabolism and disposition of acetaminophen: Recent advances in relation to hepatotoxicity and diagnosis. Pharm Res. 2013; 30 (9): 2174–2187. DOI: 10.1007/s11095–013–1007–6.McGill MR, Jaeschke H. Metabolism and disposition of acetaminophen: Recent advances in relation to hepatotoxicity and diagnosis. Pharm Res. 2013; 30 (9): 2174–2187. DOI: 10.1007/s11095–013–1007–6.Davidson DG, Eastham WN. Acute liver necrosis following overdose of paracetamol. Br Med J. 1966; 2 (5512): 497–499. DOI: 10.1136/bmj.2.5512.497.Davidson DG, Eastham WN. Acute liver necrosis following overdose of paracetamol. Br Med J. 1966; 2 (5512): 497–499. DOI: 10.1136/bmj.2.5512.497.Moles A, Torres S, Baulies A, Garcia-Ruiz C, Fernandez-Checa JC. Mitochondrial-Lysosomal Axis in Acetaminophen Hepatotoxicity. Front Pharmacol. 2018; 9: 453. Published 2018 May 15. DOI: 10.3389/fphar.2018.00453.Moles A, Torres S, Baulies A, Garcia-Ruiz C, Fernandez-Checa JC. Mitochondrial-Lysosomal Axis in Acetaminophen Hepatotoxicity. Front Pharmacol. 2018; 9: 453. Published 2018 May 15. DOI: 10.3389/fphar.2018.00453.Yoon E, Babar A, Choudhary M, Kutner M, Pyrsopoulos N. Acetaminophen-Induced Hepatotoxicity: A Comprehensive Update. J Clin Transl Hepatol. 2016; 4 (2): 131–142. DOI: 10.14218/jcth.2015.00052Yoon E, Babar A, Choudhary M, Kutner M, Pyrsopoulos N. Acetaminophen-Induced Hepatotoxicity: A Comprehensive Update. J Clin Transl Hepatol. 2016; 4 (2): 131–142. DOI: 10.14218/jcth.2015.00052Blieden M, Paramore LC, Shah D, Ben-Joseph R. A perspective on the epidemiology of acetaminophen exposure and toxicity in the United States. Expert Rev Clin Pharmacol. 2014; 7 (3): 341–348. DOI: 10.1586/17512433.2014.904744.Blieden M, Paramore LC, Shah D, Ben-Joseph R. A perspective on the epidemiology of acetaminophen exposure and toxicity in the United States. Expert Rev Clin Pharmacol. 2014; 7 (3): 341–348. DOI: 10.1586/17512433.2014.904744.Graudins A. Paracetamol poisoning in adolescents in an Australian setting: Not quite adults. Emergency Medicine Australasia [Internet]. Wiley; 2015 Mar 5; 27 (2): 139–44. Available from: http://dx.doi.org/10.1111/1742–6723.12373Graudins A. Paracetamol poisoning in adolescents in an Australian setting: Not quite adults. Emergency Medicine Australasia [Internet]. Wiley; 2015 Mar 5; 27 (2): 139–44. Available from: http://dx.doi.org/10.1111/1742–6723.12373Woolbright BL, Ramachandran A, McGill MR, et al. Lysosomal instability and cathepsin B release during acetaminophen hepatotoxicity. Basic Clin Pharmacol Toxicol. 2012; 111 (6): 417–425. DOI: 10.1111/j.1742–7843.2012.00931.x.Woolbright BL, Ramachandran A, McGill MR, et al. Lysosomal instability and cathepsin B release during acetaminophen hepatotoxicity. Basic Clin Pharmacol Toxicol. 2012; 111 (6): 417–425. DOI: 10.1111/j.1742–7843.2012.00931.x.Hayden JC, Kelly L, McNicholas F. A clinician's guide to self-poisoning with paracetamol in youth: The what, when and why? Acta Paediatr. 2020; 109 (11): 2237–2242. DOI: 10.1111/apa.15414.Hayden JC, Kelly L, McNicholas F. A clinician's guide to self-poisoning with paracetamol in youth: The what, when and why? Acta Paediatr. 2020; 109 (11): 2237–2242. DOI: 10.1111/apa.15414.EASL clinical guidelines: drug-induced liver injury. Journal of hepatology 2019 vol. 70: 1222–1261EASL clinical guidelines: drug-induced liver injury. Journal of hepatology 2019 vol. 70: 1222–1261Cummings AJ, King ML, Martin BK. A kinetic study of drug elimination: the excretion of paracetamol and its metabolites in man. Br J Pharmacol Chemother. 1967; 29 (2): 150–157. DOI: 10.1111/j.1476–5381.1967.tb01948.x.Cummings AJ, King ML, Martin BK. A kinetic study of drug elimination: the excretion of paracetamol and its metabolites in man. Br J Pharmacol Chemother. 1967; 29 (2): 150–157. DOI: 10.1111/j.1476–5381.1967.tb01948.x.Watkins PB, Kaplowitz N, Slattery JT, et al. Aminotransferase elevations in healthy adults receiving 4 grams of acetaminophen daily: A randomized controlled trial. JAMA. 2006; 296 (1): 87–93. DOI: 10.1001/jama.296.1.87.Watkins PB, Kaplowitz N, Slattery JT, et al. Aminotransferase elevations in healthy adults receiving 4 grams of acetaminophen daily: A randomized controlled trial. JAMA. 2006; 296 (1): 87–93. DOI: 10.1001/jama.296.1.87.Большая российская энциклопедия лекарственных средств. Ремедиум. 2001.Big Russian Encyclopedia of Medicines. Remedium. 2001.Herndon CM, Dankenbring DM. Patient perception and knowledge of acetaminophen in a large family medicine service. J Pain Palliat Care Pharmacother. 2014; 28 (2): 109–116. DOI: 10.3109/15360288.2014.908993.Herndon CM, Dankenbring DM. Patient perception and knowledge of acetaminophen in a large family medicine service. J Pain Palliat Care Pharmacother. 2014; 28 (2): 109–116. DOI: 10.3109/15360288.2014.908993.Dart RC, Bailey E. Does therapeutic use of acetaminophen cause acute liver failure? Pharmacotherapy. 2007; 27 (9): 1219–1230. DOI: 10.1592/phco.27.9.1219.Dart RC, Bailey E. Does therapeutic use of acetaminophen cause acute liver failure? Pharmacotherapy. 2007; 27 (9): 1219–1230. DOI: 10.1592/phco.27.9.1219.Xie Y, McGill MR, Dorko K, et al. Mechanisms of acetaminophen-induced cell death in primary human hepatocytes. Toxicol Appl Pharmacol. 2014; 279 (3): 266–274. DOI: 10.1016/j.taap.2014.05.010Xie Y, McGill MR, Dorko K, et al. Mechanisms of acetaminophen-induced cell death in primary human hepatocytes. Toxicol Appl Pharmacol. 2014; 279 (3): 266–274. DOI: 10.1016/j.taap.2014.05.010Lancaster EM, Hiatt JR, Zarrinpar A. Acetaminophen hepatotoxicity: An updated review. Arch Toxicol. 2015; 89 (2): 193–199. DOI: 10.1007/s00204–014–1432–2.Lancaster EM, Hiatt JR, Zarrinpar A. Acetaminophen hepatotoxicity: An updated review. Arch Toxicol. 2015; 89 (2): 193–199. DOI: 10.1007/s00204–014–1432–2.Jaeschke H, McGill MR, Ramachandran A. Oxidant stress, mitochondria, and cell death mechanisms in drug-induced liver injury: Lessons learned from acetaminophen hepatotoxicity. Drug Metab Rev. 2012; 44 (1): 88–106. DOI: 10.3109/03602532.2011.602688.Jaeschke H, McGill MR, Ramachandran A. Oxidant stress, mitochondria, and cell death mechanisms in drug-induced liver injury: Lessons learned from acetaminophen hepatotoxicity. Drug Metab Rev. 2012; 44 (1): 88–106. DOI: 10.3109/03602532.2011.602688.Molleston JP, Fontana RJ, Lopez MJ, et al. Characteristics of idiosyncratic drug-induced liver injury in children: Results from the DILIN prospective study. J Pediatr Gastroenterol Nutr. 2011; 53 (2): 182–189. DOI: 10.1097/mpg.0b013e31821d6cfd.Molleston JP, Fontana RJ, Lopez MJ, et al. Characteristics of idiosyncratic drug-induced liver injury in children: Results from the DILIN prospective study. J Pediatr Gastroenterol Nutr. 2011; 53 (2): 182–189. DOI: 10.1097/mpg.0b013e31821d6cfd.Maclaren R. Hepatic and cholestatic diseases. Drug-induced diseases. Prevention, detection and management. Bethesda, 2010; chapter 40, p. 771–800.Maclaren R. Hepatic and cholestatic diseases. Drug-induced diseases. Prevention, detection and management. Bethesda, 2010; chapter 40, p. 771–800.Маркова И. В., Калиничева В.И. Педиатрическая фармакология. Медицина. Ленинград 1987.Markova I. V., Kalinicheva V. I. Pediatric pharmacology. Medicine. Leningrad 1987.Andrade RJ, Lucena MI, Kaplowitz N, et al. Outcome of acute idiosyncratic drug-induced liver injury: Long-term follow-up in a hepatotoxicity registry. Hepatology. 2006; 44 (6): 1581–1588. DOI: 10.1002/hep.21424.Andrade RJ, Lucena MI, Kaplowitz N, et al. Outcome of acute idiosyncratic drug-induced liver injury: Long-term follow-up in a hepatotoxicity registry. Hepatology. 2006; 44 (6): 1581–1588. DOI: 10.1002/hep.21424.Gulati K, Reshi MR, Rai N, Ray A. Hepatotoxicity: Its Mechanisms, Experimental Evaluation and Protective Strategies. Am J Pharmacol. 2018; 1 (1): 1004.Gulati K, Reshi MR, Rai N, Ray A. Hepatotoxicity: Its Mechanisms, Experimental Evaluation and Protective Strategies. Am J Pharmacol. 2018; 1 (1): 1004.Abboud G, Kaplowitz N. Drug-induced liver injury. Drug Saf. 2007; 30 (4): 277–294. DOI: 10.2165/00002018–200730040–00001.Abboud G, Kaplowitz N. Drug-induced liver injury. Drug Saf. 2007; 30 (4): 277–294. DOI: 10.2165/00002018–200730040–00001.de Abajo FJ, Montero D, Madurga M, García Rodríguez LA. Acute and clinically relevant drug-induced liver injury: A population-based case-control study. Br J Clin Pharmacol. 2004; 58 (1): 71–80. DOI: 10.1111/j.1365–2125.2004.02133.x.de Abajo FJ, Montero D, Madurga M, García Rodríguez LA. Acute and clinically relevant drug-induced liver injury: A population-based case-control study. Br J Clin Pharmacol. 2004; 58 (1): 71–80. DOI: 10.1111/j.1365–2125.2004.02133.x.Rumack BH, Peterson RG. Acetaminophen overdose: Incidence, diagnosis, and management in 416 patients. Pediatrics. 1978; 62 (5 Pt 2 Suppl): 898–903.Rumack BH, Peterson RG. Acetaminophen overdose: Incidence, diagnosis, and management in 416 patients. Pediatrics. 1978; 62 (5 Pt 2 Suppl): 898–903.Rossi S, Assis DN, Awsare M, et al. Use of over-the-counter analgesics in patients with chronic liver disease: Physicians' recommendations. Drug Saf. 2008; 31 (3): 261–270. DOI: 10.2165/00002018–200831030–00007.Rossi S, Assis DN, Awsare M, et al. Use of over-the-counter analgesics in patients with chronic liver disease: Physicians' recommendations. Drug Saf. 2008; 31 (3): 261–270. DOI: 10.2165/00002018–200831030–00007.

The authors declare that there are no conflicts of interest present.