ABSTRACT. The hepatotoxicity of paracetamol in mice of 2, 3, 8-10, 24-26, 32-34, and 52-54 wk of age was determined by lethality data, histopathologic examination of the liver, and appearance of glutamate-pyruvate transaminase and glutamate-oxaloacetate transaminase activities in the plasma over an 8-h exposure period. At a dose of 300 mg/kg, there was evidence of hepatocytic necrosis and transaminase leakage in the 32-to 34-and 52-to 54-wk-old mice, but lethality was only recorded in the oldest age group. At 500 mg/kg, paracetamol produced 30% lethality in 3-wk-old mice and between 50 and 90% lethality in the adult age groups. There was histologic evidence of hepatocytic necrosis at all of these ages and its extent increased with age. Similarly, there were increases in plasma transaminases in each of these age groups. However, in 2-wk-old mice there was no lethality, no hepatocytic necrosis, and no increase in plasma transaminases. The lack of susceptibility of 2-wk-old mice to paracetamol toxicity was not due to immaturity of the cytochrome P-450 enzymes responsible for metabolism of paracetamol to its reactive metabolite (N-acetyl-p-benzoquinone imine). In fact, the activity of this enzyme pathway in 2-wk-old mice was greater than that in adults. The partial clearance of the glutathione-derived metabolites of paracetamol after a nontoxic (50 mg/kg) dose was 80% greater in 2-wk-old mice than in 8-to 10-wk-old mice. Therefore, despite having greater capacity to generate N-acetyl-p-benzoquinone imine, 2-wk-old mice had no hepatotoxic effects from a dose that killed at least 50% of adult mice. Factors that relate to the detoxification of N-acetyl-p-benzoquinone imine in the liver are implicated in the lesser susceptibility of postnatal mice to paracetamol toxicity. (Pediatr Res 29: 496-499,1991) to detoxify this metabolite by conjugation to GSH (2-4), and a number of incompletely understood processes initiated by NAPQI that lead to cell death (5).It is generally accepted that children are less susceptible to paracetamol toxicity than are adults (6). This impression has developed from clinical observations that the incidence of overdose toxicity is less in the young (7). However, the scientific basis for this has yet to be confirmed.Our present study is aimed at examining developmental aspects of the susceptibility of mice to paracetamol toxicity. Previous work in this field has been conflicting, with some research indicating that young mice (8) and rats (9) are more susceptible to high doses of paracetamol. However, the majority of findings indicate that during the postnatal period young rats and mice are less susceptible to toxicity (10, II). These latter observations have been attributed to the immaturity of the cytochrome P-450-linked mixed function oxidase enzymes in the postnatal period and the consequent decrease in the rate of activation of paracetamol to NAPQI (10) or to a lack of susceptibility to hepatotoxins in general (12). We have recently observed that hepatocytes from postnatal mice are less su...