Abstract
ACETAMINOPHEN is a commonly prescribed antipyretic and nonnarcotic analgesic with only occasional serious side effects. Leukopenia and a maculopapular rash have been observed during routine use, and hepatotoxic reactions and renal failure have been noted after overdosage. We report a case of near fatal massive hemolysis (Coombs-positive) caused by acetaminophen at customarily used doses. <h3>Report of a Case</h3> A 37-year-old man was admitted to the Shmuel Harofe Hospital on June 4, 1975. The patient was acutely ill, with icterus and a slaty-blue cyanosis. He was shivering and had a temperature of 39.5 C. The spleen was palpable 2 cm below the left costal margin. The patient had been treated intermittently for two months with acetaminophen in dosages of up to three 0.5-gm tablets daily for backache, whereafter he experienced several incidents of shivering and the passage of dark urine, the severest occurring before admission. His hemoglobin level was 7.9 gm/100
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