title: Fatal anaphylactoid reaction to N-acetylcysteine: caution in patients with asthma.
abstract: 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.
authors.affiliation: Queen Alexandra Hospital, Portsmouth, UK. andy.bec@virgin.net
authors.forename: A V
authors.initials: AV
authors.lastname: Appelboam
authors.forename: P I
authors.initials: PI
authors.lastname: Dargan
authors.forename: J
authors.initials: J
authors.lastname: Knighton
mesh_terms: 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
chemical_list: D018712:Analgesics, Non-Narcotic; D000931:Antidotes; D000082:Acetaminophen; D000111:Acetylcysteine