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CASE REPORT article

Front. Toxicol.
Sec. Clinical Toxicology
Volume 6 - 2024 | doi: 10.3389/ftox.2024.1502716

N-Acetylcysteine use in a cocaine-induced liver failure: a case report

Provisionally accepted
Vanessa Biering Vanessa Biering 1Ronan Bellouard Ronan Bellouard 1,2Maëlle Martin Maëlle Martin 3Eric Dailly Eric Dailly 1,2Catherine Ganière Catherine Ganière 1Edouard Charles Le Carpentier Edouard Charles Le Carpentier 1*
  • 1 Laboratoire de pharmacologie clinique, CHU Nantes, Nantes, France
  • 2 Cibles et Médicaments des Infections et de l’Immunité, UR1155 IIciMED, Université de Nantes, Nantes, France
  • 3 Médecine Intensive Réanimation, CHU Nantes, Nantes, France

The final, formatted version of the article will be published soon.

    Background: Cocaine intoxication and abuse is a worldwide problem and can be the cause of numerous acute medical complications, including severe acute hepatitis. Although these cases are scare, they are extremely serious and may lead to liver transplantation or death. Management of toxic hepatitis, once the causative agent has been discontinued, is essentially symptomatic, based on clinical and biological monitoring and prevention of complications related to acute hepatitis. Case details: We present a case of a 28-year-old woman admitted to the emergency department for acute hepatitis due to cocaine intoxication. In addition to a sharp rise in her liver enzymes, the patient also presented metabolic acidosis, renal failure, and rhabdomyolysis. Treatment consisted in the administration of N-acetylcysteine, dialysis and additional supportive measures. An improvement of the liver function with a decrease of transaminases occurred after the NAC administration. The toxicokinetics of major cocaine metabolites and clinical chemistry concentrations were monitored. Conclusions: In addition to the usual management measures for acute hepatitis, the administration of N-acetylcysteine should be investigated further, although it is currently used only in cases of acetaminophen acute toxic hepatitis.

    Keywords: Cocaine, toxicokinetics, N-acetylcystein, Intensive care unit (ICU), Liver injuries

    Received: 27 Sep 2024; Accepted: 16 Dec 2024.

    Copyright: © 2024 Biering, Bellouard, Martin, Dailly, Ganière and Le Carpentier. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Edouard Charles Le Carpentier, Laboratoire de pharmacologie clinique, CHU Nantes, Nantes, France

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