A Cautionary Tale: Acute Hepatitis In The Rehab Unit

I recently treated a patient who was hospitalized with paraplegia. During some routine lab testing I noticed that his liver function tests were elevated, and so I began looking for a cause. I discussed the patient’s drinking habits (he rarely drank alcohol), risks for viral hepatitis (no IV drug use or exposure to those with known hepatitis), and general medical history (nothing relevant to liver disease). I reviewed his current medication list, and found little to explain a potential drug-induced hepatitis. He denied any history of acetaminophen use. Next I ordered a hepatitis panel – all normal. And finally a liver ultrasound (which showed some non-descript “fatty liver” changes). My next best guess was that the patient was a heavy drinker who was simply not telling me the whole story about his history. I hated to have to press for more information, and worried that the patient would be annoyed that I didn’t seem to believe his vehement denials of regular alcohol use. So I asked him again. “Are you SURE you don’t drink ANY alcohol? Nothing that could have alcohol in it that you might not realize?” “Well, maybe there is alcohol in the cold medicine that I drink?” he said. “Why are you drinking cold medicine? Do you have cold symptoms?” I asked. “I use it to get to sleep at night.” He responded. “How much do you use?” “I use it every night. I just drink it out of the bottle.&...
Source: Better Health - Category: American Health Authors: Tags: Health Tips True Stories Acetaminophen Alcohol Cold Medicine Drinking Cold Medicine Hepatitis Liquid Liver Damage Liver Failure NyQuil Overdose Source Type: blogs