{Reference Type}: Case Reports
{Title}: N-Acetylcysteine treatment of neonatal acetaminophen toxicity caused by transplacental transfer - a case report.
{Author}: McDougall G;Murphy NG;Loubani O;
{Journal}: Clin Toxicol (Phila)
{Volume}: 59
{Issue}: 9
{Year}: Sep 2021
{Factor}: 3.738
{DOI}: 10.1080/15563650.2021.1874405
{Abstract}: We describe a case of maternal acetaminophen toxicity leading to Caesarean section delivery of a pre-term neonate with acetaminophen-induced hepatic injury and encephalopathy at 33 weeks gestational age. Delayed treatment with N-acetylcysteine (NAC) was initiated in the baby 11 h after delivery, with eventual discharge of a healthy baby at 12 days of age. The baby was treated with a standard but extended duration NAC protocol. Post-operatively, liver biopsy of the mother demonstrated acetaminophen-induced hepatic injury overlying mild hepatic steatosis. This was also managed with NAC therapy leading to complete clinical resolution of acetaminophen induced hepatic injury and discharge on post-operative day 10. This case of delayed NAC therapy for the treatment of pre-term neonatal acetaminophen toxicity is one of very few reported in the literature and can be used as a guide in the management of subsequent cases.