The patient presentation is not due to paracetamol overdose

Are you sure? The lab pattern, very high aminotransferases with early relatively modest bilirubin, marked coagulopathy (INR 7.2), and acute kidney injury (creatinine 405 micromol/L), is highly consistent with paracetamol-induced acute liver failure. A negative level late after ingestion does not rule it out.

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