A successfully treated case with brain atrophy and fulminant hepatitis induced by overdosage of taking analgesics on the market

A 39-year-old-woman with fulminant hepatitis is presented. Since 20 years of age, she had habitual use of bromides, 20 tablets daily, because of severe menorrhalgia and headache. In 1982, headache and convulsion had developed. Computed tomography (CT) revealed brain atrophy. Since then, she took Sedes A as much as 40 tablets daily. In 1985, she felt general fatigue, abdominal pain and diarrhea. Laboratory data revealed severe liver dysfunction and prolonged prothrombin time. Then she was transferred to our hospital with suspicion of fulminant hepatitis in August 18. Plasma exchange and glucose-glucagon-insulin therapy were effective. In 12th hospital day, she had Jacksonian's type convulsion attack. Brain CT showed the atrophy of bilateral frontal lobes. The cause of the hepatic failure was thought to be due to acetaminophen over-dose because both IgM-type of anti-HBc and anti-HA were negative. Long-term bromides overdosage might be an underlying etiology of her brain atrophy.