N-acetylcysteine (NAC) is a mucolytic agent (Mucomyst, Mead-Johnson) that is often used for the treatment of meconium ileus equivalent, a complication of cystic fibrosis.1-3 No serious adverse reactions to nonparenterally administered NAC have been observed, and there have been no reports of significant hepatotoxicity. We describe a patient in whom severe hepatic dysfunction occurred on two occasions after the administration of NAC for the treatment of meconium ileus equivalent.
CASE REPORT
A 3-year-old, 12.5-kg, white boy with cystic fibrosis was admitted for treatment of a fractured left femur. His medications included theophylline, metaproterenol, cefaclor, nebulized isoethanine, and pancreatic enzyme replacement with meals.