Abstract
To the Editor.— The Rumack-Matthew nomogram has been useful in predicting hepatotoxicity following single, acute acetaminophen ingestions.1 We report a case of acetaminophen hepatotoxicity to emphasize the lack of predictive value of the nomogram if the ingestion occurs during a prolonged period. A 16-year-old girl reportedly ingested between 7.5 and 10 g of acetaminophen during a 4-hour period (7:00 to 11:00 am). She vomited twice spontaneously between 11:00 am and 3:30 pm A serum acetaminophen concentration drawn at 3:15 pm was 114 mg/L.
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