La Revue du praticien
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Acute ingestion of acetaminophen can induce a dose-dependent hepatotoxicity and lead to death. The management of acute acetaminophen poisoning at the early stage is well codified. A reported amount of ingestion > 200 mg/kg in a child, > 150 mg/kg in an adult (125 mg/kg if risk factors are present) require hospitalisation. ⋯ NAC is indicated if the serum acetaminophen level drawn 4 hours after ingestion and plotted on the nomograme falls above the "200 mg/L-4 hours" line. Nomograme is not usable with repeated acute ingestion or repeated supratherapeutic doses; presence of risk factors (enzymatic induction, malnutrition, chronic alcoholism) must be taken into account ("100 mg/L - 4 hours" line). Outcome is favorable with respect to these conditions.
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The vasculitides involving the lower respiratory tract are mainly the small vessels vasculitides associated with antineutrophil cytoplasmic autoantibodies including Wegener granulomatosis (WG), microscopic polyangiitis (MPA), and Churg-Strauss syndrome (SCS). WG pulmonary manifestations mainly consist of nodules and pneumonias often cavitary, and tracheobronchial stenoses. ⋯ In SCS, asthma with eosinophilia and further eosinophilic pneumonia are the characteristic pulmonary features. Lung biopsy may be necessary in WG to obtain a definite diagnosis when no other site for biopsy is possible.