[A prospective study on suicide attempts by self-poisoning in adolescents: Symptoms and complications]. / Intoxications médicamenteuses volontaires chez 58 adolescents : étude prospective sur l'impact somatique et les complications biologiques.

AIM: Biological complications in adolescents' self-poisoning are not currently evaluated. The aim of this study was to describe the toxicological characteristics of suicide attempts, the ingested substances, and their complications to better prevent the risks associated with deliberate self-poisoning. MATERIALS AND METHODS: This was a descriptive, prospective, single-center study. It took place in the pediatric emergency, hospitalization, and intensive care unit of the Caen University Hospital. All children aged 10-18years who had presented to the pediatric emergency department between 1 June 2012 and 1 June 2013 for deliberate self-poisoning were included. Somatic evaluation was conducted for the protocol on arrival at the emergency room, and repeated during hospitalization, and biological evaluation was performed on arrival at the pediatric emergency unit and on the 5th day after the drug intoxication. A questionnaire was completed at this time to identify the substances ingested and the risk factors for suicide attempt. RESULTS: Acetaminophen was the most frequently chosen substance compared to other drugs in acute drug overdose (P=0.01). Abdominal pain on arrival at the emergency room were significantly associated with acetaminophen (P=0.02). In 10% of the cases, a transfer to the pediatric intensive care unit was required. In total, 3.4% had acute renal failure and 3.4% acute liver failure in connection with acetaminophen ingestion. Biological complications and symptoms disappeared prior to hospital discharge. The average hospital stay was 7.1 days. DISCUSSION: This study focused on biological complications in pediatric emergencies, but also later on deliberate self-poisoning to detect other complications. It seems important to detect the presence of liver or kidney failure, and more importantly whether there is acetaminophen ingestion. The prevention of suicide attempt recurrences also remains a priority, given the increased risk of mortality from repeating a suicide attempt. Systematization of biological assessments made in emergency situations but particularly in the hospital could improve the care of these adolescents.

[Acetaminophen (paracetamol) causing renal failure: report on 3 pediatric cases]. / Insuffisance rénale secondaire à une intoxication au paracétamol: à propos de 3 cas.

Renal failure secondary to acetaminophen poisoning is rare and occurs in approximately 1-2 % of patients with acetaminophen overdose. The pathophysiology is still being debated, and renal acetaminophen toxicity consists of acute tubular necrosis, without complication if treated promptly. Renal involvement can sometimes occur without prior liver disease, and early renal manifestations usually occur between the 2nd and 7th day after the acute acetaminophen poisoning. While therapy is exclusively symptomatic, sometimes serious metabolic complications can be observed. The monitoring of renal function should therefore be considered as an integral part of the management of children with acute, severe acetaminophen intoxication. We report 3 cases of adolescents who presented with acute renal failure as a result of voluntary drug intoxication with acetaminophen. One of these 3 girls developed severe renal injury without elevated hepatic transaminases. None of the 3 girls' renal function required hemodialysis, but one of the 3 patients had metabolic complications after her acetaminophen poisoning.