Fatal anaphylactoid reaction to N-acetylcysteine: caution in patients with asthma

Emerg Med J. 2002 Nov;19(6):594-5. doi: 10.1136/emj.19.6.594.


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.

Publication types

  • Case Reports

MeSH terms

  • Acetaminophen / poisoning*
  • Acetylcysteine / adverse effects*
  • Adult
  • Analgesics, Non-Narcotic / poisoning*
  • Anaphylaxis / chemically induced*
  • Antidotes / adverse effects*
  • Asthma / complications*
  • Fatal Outcome
  • Female
  • Humans
  • Hypoxia, Brain / chemically induced


  • Analgesics, Non-Narcotic
  • Antidotes
  • Acetaminophen
  • Acetylcysteine