@article {J.:February 2003:0954-6820:240,
	author = "J. Kurtovic",
	author = "S. M. Riordan",
	title = "Paracetamol-induced hepatotoxicity at recommended dosage",
	journal = "Journal of Internal Medicine",
	volume = "253",
	year = "February 2003",
	abstract = "<B>Abstract.</B> Kurtovic J, Riordan SM (The Prince of Wales Hospital and University of New South Wales, Sydney, Australia). Paracetamol-induced hepatotoxicity at recommended dosage (Case report). <I>J Intern Med</I> 2003; <B>253:</B> 240&#150;243. <P></P>In patients who develop liver damage following moderate paracetamol overdose in the order of 5&#150;10 g daily, recent fasting and nutritional impairment have been identified as key precipitants. Hepatotoxicity caused by paracetamol at recommended dosage, in the absence of exposure to enzyme-inducing drugs, has recently been described as an idiosyncratic phenomenon. The possible importance of fasting and malnutrition in this setting is uncertain. We report a severely malnourished 53-year-old woman who developed severe hepatotoxicity whilst receiving paracetamol at recommended dosage (4 g daily) following a period of fasting, in the absence of enzyme-inducing agents. Subsequent paracetamol exposure up to 2.6 g daily thrice weekly, in the setting of ongoing malnutrition and fasting as before, did not lead to recurrent liver damage. These findings indicate that paracetamol-related liver damage occurring within recommended dosage guidelines can be a dose-dependent rather than necessarily idiosyncratic phenomenon, at least in the setting of recent fasting and severe malnutrition.",
	pages = "240-243(4)",
	url = "http://www.ingentaconnect.com/content/bsc/jint/2003/00000253/00000002/art00019"
	doi = "doi:10.1046/j.1365-2796.2003.01097.x"
}