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Acute liver failure secondary to therapeutic paracetamol dosing in an extremely preterm neonate
  1. Krishna Raghu1,2 and
  2. Mary Judith Berry1,2,3
  1. 1Department of Paediatrics and Child Health, University of Otago, Wellington, New Zealand
  2. 2Neonatal Intensive Care Unit, Wellington Regional Hospital, Wellington, New Zealand
  3. 3Centre for Translational Physiology, University of Otago, Wellington, New Zealand
  1. Correspondence to Dr Krishna Raghu; krishna.raghu{at}


We report the first case of standard therapeutic dose paracetamol for patent ductus arteriosus closure causing acute liver failure in an extremely preterm infant. After 5 days of treatment, he presented with jaundice, acute severe hepatitis and coagulopathy. Treatment with N-acetyl cysteine resulted in full recovery.

  • Neonatal intensive care
  • Gastrointestinal system
  • Liver disease
  • Unwanted effects / adverse reactions

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  • Contributors KR and MJB have made equal contributions to the planning, design and conception of this report. Review of records and acquisition of data was obtained by KR. The analysis and interpretation of data was done jointly by KR and MJB. An initial draft was formulated by KR and reviewed and revised critically by MJB. Final approval of the version to be published was done jointly by KR and MJB. Both authors are in agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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