Prognosis

In survivors, hepatic regeneration is normally rapid and complete, with normalisation of liver function tests within 1 to 3 weeks.[67][68][69] Renal injury is rare, and when it occurs serum creatinine typically begins to rise soon after serum aminotransferase activity has peaked. Occasionally, renal injury occurs without liver injury.[70][71]

In unselected patients referred to hospital without specific therapy, <10% developed hepatotoxicity; 1% developed acute renal failure; and 1% to 2% died in hepatic failure.[72] Several studies have identified an increased risk of severe hepatotoxicity and higher mortality in patients with staggered overdoses or delayed presentation.[19][20][21][73]

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