Fatal anaphylactoid reaction to N-acetylcysteine: caution in patients with asthma.
Paracetamol overdose is a common reason for presentation to the emergency department and N-acetylcysteine is frequently used in the treatment of toxic paracetamol ingestions. Adverse reactions to N-acetylcysteine are common though usually mild and easily treated. Serious reactions to N-acetylcysteine however, are rare and there have been no previous reported fatalities with its therapeutic use. This report describes the case of a 40 year old brittle asthmatic patient who died after treatment with intravenous N-acetylcysteine. Asthma is a risk factor for adverse reactions to N-acetylcysteine and special caution should be exercised in its use in brittle asthmatic patients.
Appelboam
A V
AV
Queen Alexandra Hospital, Portsmouth, UK. andy.bec@virgin.net
Dargan
P I
PI
Knighton
J
J
D000082:Acetaminophen / Q000506:poisoning*; D000111:Acetylcysteine / Q000009:adverse effects*; D000328:Adult; D018712:Analgesics, Non-Narcotic / Q000506:poisoning*; D000707:Anaphylaxis / Q000139:chemically induced*; D000931:Antidotes / Q000009:adverse effects*; D001249:Asthma / Q000150:complications*; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D002534:Hypoxia, Brain / Q000139:chemically induced
D018712:Analgesics, Non-Narcotic; D000931:Antidotes; D000082:Acetaminophen; D000111:Acetylcysteine