Rhabdomyolysis with acute renal failure and disseminated intravascular coagulation: Association with acetaminophen and ethanol

A 45-year-old man presented in acute shock due to fulminant disseminated intravascular coagulation, Despite supportive efforts, the patient died less than 24 hours later. Laboratory studies suggested rhabdomyolysis with acute renal failure as the precipitating cause of the disseminated intravascular coagulation. Postmortem pathological examination of the kidney demonstrated acute tubular necrosis with prominent casts consistent with myoglobinuria, The patient had regularly consumed moderate amounts of ethanol for several years, Three weeks prior to his death, he began taking therapeutic amounts of acetaminophen daily for mild ''flu-like'' symptoms. Acetaminophen may precipitate rhabdomyolysis in chronic ethanol users.