Severe Paracetamol Overdose Resulting in Acute Hepatotoxicity: A Case Report and Therapeutic Approaches

BACKGROUND: Paracetamol (acetaminophen) overdose is a significant public health concern due to its potential to cause severe liver damage and acute liver failure. Prompt identification and treatment are critical in managing this condition. N-acetylcysteine (NAC) is a cornerstone treatment for preventing liver damage in such cases. This report focuses on an 18-year-old woman who experienced severe liver toxicity following an overdose of paracetamol and cetirizine, underscoring the importance of early intervention and comprehensive care. CASE PRESENTATION: An 18-year-old woman presented to the emergency department with altered consciousness and abdominal pain after ingesting a substantial quantity of paracetamol and cetirizine. Initial management included gastric lavage. Her treatment regimen comprised supportive care, administration of NAC, and psychiatric evaluation. Over the course of three days, the patient's clinical condition improved significantly, with normalization of laboratory parameters and resolution of symptoms. She was subsequently discharged with psychiatric medications to manage underlying psychological issues contributing to the overdose. CONCLUSION: This case underscores the critical need for rapid recognition, appropriate intervention, and holistic care in the management of paracetamol overdose. The favorable outcome in this patient highlights the efficacy of NAC in preventing liver damage and the importance of psychiatric support in addressing the psychological aspects of overdose. A multidisciplinary approach is essential for the effective treatment of both the medical and psychological dimensions of overdose cases.