Two patients experienced acute transient hepatic and renal failure following ingestion of substantial but less than the usually toxic doses of acetaminophen, in both cases associated with heavy acute alcohol intake. One patient developed transient clinical features of chronic active liver disease one month later. Liver biopsy specimens from both patients taken after the acute episodes revealed, in addition to the well recognized centrilobular hepatic injury of acetaminophen, unusual portal tract lesions, which resembled chronic active hepatitis in one case. In some patients therapeutic doses of acetaminophen, if taken together with alcohol, may produce acute and chronic liver disease.
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