Necrosis, liver, acetaminophen overdose induced

Figure 5. Acetaminophen overdose induces liver necrosis by formation of more hepatotoxin (metabolite A) than can be deactivated by glutathione conjugation (metabolite B). ...

Grewal KK, Racz WJ (1993) Intracellular calcium disruption as a secondary event in acetaminophen-induced hepatotoxicity. Can J Physiol Pharmacol 71 26-33 Gujral JS, Knight TR, Earhood A, Bajt ML, Jaeschke H (2002) Mode of cell death after acetaminophen overdose in mice apoptosis or oncotic necrosis Toxicol Sci 67 322-328 Gujral JS, Hinson JA, Earhood A, Jaeschke H (2004) NADPH oxidase-derived oxidant stress is critical for neutrophil cytotoxicity during endotoxemia. Am J Physiol Gastrointest Liver Physiol 287 G243-252... 

Acute overdose with acetaminophen (>300 mg kg ) results in hepatotoxicity and/or nephrotoxicity. Although hepatotoxicity is frequently the predominant toxicity, acetaminophen nephrotoxicity can occur in the absence of marked hepatic toxicity. In these cases, liver function returns to normal or near normal levels before the onset of nephrotoxicity. Acute acetaminophen nephrotoxicity is generally characterized as oliguric acute renal failure with acute tubular necrosis. Acetaminophen can also induce acute nephrotoxicity in therapeutic doses, but chronic alcohol intake usually accompanies renal toxicity in these patients. 

---