Which organs are primarily affected by radical injury caused by acetaminophen?

Radical injury caused by acetaminophen primarily affects the liver and kidney due to the way acetaminophen is metabolized and its toxic effects on these organs. Acetaminophen, when taken in therapeutic doses, is generally safe; however, an overdose can lead to the saturation of its normal metabolic pathways, particularly the glucuronidation and sulfation pathways. When these pathways are overwhelmed, a harmful metabolite called N-acetyl-p-benzoquinone imine (NAPQI) is produced.

The liver is the primary organ involved in metabolizing acetaminophen, and NAPQI can cause oxidative stress and hepatic cell death. This leads to hepatotoxicity, which is the most clinically significant outcome of acetaminophen overdose. Symptoms may include elevated liver enzymes, jaundice, and in severe cases, acute liver failure.

The kidneys can also be affected by acetaminophen toxicity, particularly in the setting of chronic use or overdose. The renal tubules are susceptible to injury from the same oxidative stress caused by NAPQI. Renal injury can manifest as acute kidney injury, characterized by decreased urine output, increased serum creatinine, and electrolyte imbalances.

The other organs mentioned, such as the heart, spleen, and