Young women self poisoning with massive ingestion of paracetamol (acetaminophen): autopsy and histological findings

We report a case of a 26-year-old woman attempted suicide who ingested about 100 tablets of Defalgan® 1 g, which is composed by paracetamol (Acetaminophen). The young girl was recovered in Intensive Care Unit; the serum paracetamol level was 737 mg/l (normal value<20 mg/l). N-acetylcycteine infusion was started at admission, and the woman seemed to be better. The day after the clinical condition worsened and patient developed severe liver failure with alteration of coagulation factors (early developed in disseminated intravascular coagulation), acute renal failure, anemia, agranulocytosis and hypoxemic respiratory failure caused by pneumonia. The woman died five days after the self-poisoning because of multi-organ failure. We report our autopsy and histological findings, which can demonstrate the characteristic cellular damages caused by paracetamol, comparing to literature review.