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Frontiers of Medicine

ISSN 2095-0217

ISSN 2095-0225(Online)

CN 11-5983/R

Postal Subscription Code 80-967

2018 Impact Factor: 1.847

Front. Med.    2015, Vol. 9 Issue (3) : 388-391     DOI: 10.1007/s11684-015-0398-7
CASE REPORT |
Severe hepatoxicity caused by aspirin overdose: a case report
Zhuping Cao1,Shiqi Liu2,*(),Jianhua Niu3,Bing Wei4,Jie Xu5
1. Department of Nursing, School of Medicine, Shihezi University, Shihezi 832002, China
2. Department of Pediatric Surgery, The Affiliated Northwest Women’s and Children’s Hospital, Xi’an Jiaotong University, Xi’an 710003, China
3. Third Department of General Surgery, The First Affiliated Hospital, School of Medicine, Shihezi University, Shihezi 832002, China
4. Department of Medical Administration, The First Affiliated Hospital, Shihezi University, Shihezi 832002, China
5. Department of Emergency, The First Affiliated Hospital, Shihezi University, Shihezi 832002, China
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Abstract  

We report here the rare case of a 61-year-old man with multiple organ dysfunction caused by an aspirin overdose (4 g orally). The patient presented with a fever that reached 39.2 °C, a peptic ulcer, and massive upper gastrointestinal bleeding. His blood test results were as follows: white blood cell count, 1.8×109/L; absolute lymphocytes, 0.4×109/L; absolute neutrophils, 1.2×109/L; and electrolyte disturbances. A computed tomography (CT) scan showed evidence of bilateral inferior pulmonary infection and acute pancreatitis. Thick dark bile with visible floccule was drawn via a percutaneous transhepatic cholangiodrainage (PTCD). Klebsiella pneumoniae was detected in microbiological bile tests. Two years later, the patient died of chronic liver failure.

Keywords aspirin      side effects      liver failure     
Corresponding Authors: Shiqi Liu   
Just Accepted Date: 26 May 2015   Online First Date: 18 June 2015    Issue Date: 26 August 2015
URL:  
http://academic.hep.com.cn/fmd/EN/10.1007/s11684-015-0398-7     OR     http://academic.hep.com.cn/fmd/EN/Y2015/V9/I3/388
Parameter Results
September 6, 2007 September 11, 2007 September 25, 2009
White blood cell count 1.8 × 109/L 12.1 × 109/L 3.5 × 109/L
Neutrophils 68.4% 82.9% 83.5%
Absolute lymphocytes 0.4 × 109/L 0.37 × 109/L 0.3 × 109/L
Absolute neutrophils 1.2 × 109/L 1.6 × 109/L 2.9 × 109/L
Lymphocytes 23.9% 24% 9.7%
Hemoglobin 155 g/L 132 g/L 154 g/L
Platelets 224 × 109/L 178 × 109/L 99 × 109/L
Serum sodium 130 mmol/L 125 mmol/L 132.1 mmol/L
Serum potassium 3.14 mmol/L 4 mmol/L 4.59 mmol/L
Serum chloride 91 mmol/L 88 mmol/L 94.1 mmol/L
Serum calcium 1.92 mmol/L 1.75 mmol/L 2.14 mmol/L
Serum amylases Negative Negative Negative
Urinary amylases Negative Negative Negative
Urine bilirubin Positive Positive Positive
Urine protein Positive Positive Positive
Urine acetone bodies Positive Negative Negative
Urine occult blood Positive Negative Positive
Acetone body Positive Positive Positive
Urine glucose Positive Negative Negative
Fecal pus cells Positive Negative Negative
HAsAg Negative Negative Negative
HBsAg Negative Negative Positive
HCsAg Negative Negative Negative
HEsAg Negative Negative Negative
Total protein 60.7 g/L 47.1 g/L 66.2 g/L
Albumin 39 g/L 22.6 g/L 41.2 g/L
Total bilirubin 90.2 μmol/L 310.2 μmol/L 99 μmol/L
Direct bilirubin 55 μmol/L 207.0 μmol/L 72.2 μmol/L
Indirect bilirubin 35.2 μmol/L 103.2 μmol/L 26.8 μmol/L
ALT 142 U/L 133 U/L 7790 U/L
Aspartate aminotransferase 54 U/L 61 U/L 5293 U/L
Lactate dehydrogenase 6573 U/L
Tab.1  Laboratory test results
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