High-Dose N-Acetylcysteine Therapy for Novel H1N1 Influenza Pneumonia

Letters18 May 2010High-Dose N-Acetylcysteine Therapy for Novel H1N1 Influenza PneumoniaKang Yiu Lai, MRCP, Wing Yiu Ng, MRCP, Pik Kei Osburga Chan, MRCP, Kit Fai Wong, MD, MRCP, and Fanny Cheng, MRCPKang Yiu Lai, MRCPFrom Queen Elizabeth Hospital, Kowloon, Hong Kong., Wing Yiu Ng, MRCPFrom Queen Elizabeth Hospital, Kowloon, Hong Kong., Pik Kei Osburga Chan, MRCPFrom Queen Elizabeth Hospital, Kowloon, Hong Kong., Kit Fai Wong, MD, MRCPFrom Queen Elizabeth Hospital, Kowloon, Hong Kong., and Fanny Cheng, MRCPFrom Queen Elizabeth Hospital, Kowloon, Hong Kong.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-152-10-201005180-00017 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Background: High-dose N-acetylcysteine synergizes with oseltamivir to protect mice from fatal influenza infection.Objective: To show the potential role of N-acetylcysteine in the treatment of novel H1N1 influenza pneumonia in a dose used to treat acetaminophen overdose.Case Report: On 15 July 2009, we admitted a previously healthy woman to the intensive care unit in a Hong Kong hospital for novel H1N1 human swine influenza (H1N1) pneumonia with septic shock and type 1 respiratory failure. She was 48 years of age, was not obese, and was a long-term smoker. She required pressure-controlled ventilation with 100% oxygen, 18-cm H2O positive end-expiratory ...References1. Knobil K, Choi AMK, Weigand GW, Kacoby DB. Role of oxidants in influenza virus-induced gene expression. Am J Physiol Lung Cell Mol Physiol. 1998;274:L134-42. CrossrefGoogle Scholar2. Nimmerjahn F, Dudziak D, Dirmeier U, Hobom G, Riedel A, Schlee M, et al. Active NF-kappaB signalling is a prerequisite for influenza virus infection. J Gen Virol. 2004;85:2347-56. [PMID: 15269376] CrossrefMedlineGoogle Scholar3. Garozzo A, Tempera G, Ungheri D, Timpanaro R, Castro A. N-acetylcysteine synergizes with oseltamivir in protecting mice from lethal influenza infection. Int J Immunopathol Pharmacol. 2007;20:349-54. [PMID: 17624247] CrossrefMedlineGoogle Scholar4. De Flora S, Grassi C, Carati L. Attenuation of influenza-like symptomatology and improvement of cell-mediated immunity with long-term N-acetylcysteine treatment. Eur Respir J. 1997;10:1535-41. [PMID: 9230243] CrossrefMedlineGoogle Scholar5. Kaiser L, Fritz RS, Straus SE, Gubareva L, Hayden FG. Symptom pathogenesis during acute influenza: interleukin-6 and other cytokine responses. J Med Virol. 2001;64:262-8. [PMID: 11424113] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Queen Elizabeth Hospital, Kowloon, Hong Kong.Disclosures: None disclosed. 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