Reactions 433 - 9 Jan 1993

★Theophylline

Choreiform movements with an oral preparation in achild: case report

Choreiform movements were observed in an 8-year-old boywhen he was treated with oral theophylline (Slo-bid®).

Following an acute asthma attack, the boy had been givenSlo-bid® 18 mg/kg/day, prednisone and albuterol [salbutamol]on discharge. Three days later, he returned in statusasthmaticus with a serum theophylline concentration of 9.8µg/ml. He was treated with nebulized albuterol, IVaminophylline and methylprednisolone. Two hours later, hisserum theophylline concentration was 16.4 µg/ml andcontinuous shaking of his right upper extremity was noted.

After marked improvement of his asthma, his medicationwas changed to Slo-bid® 18 mg/kg/day and prednisone; 72hafter admission his serum theophylline concentration was 10.1µg/ml. The tremor was now violent, had become generalizedand was accompanied by choreiform movements. This ceasedon discontinuation of all therapy and recurred when Slo-bid®

6 mg/kg as administered 24h later; symptoms resolved within3 hours.

Author comment: ‘Our experience with this patient suggeststhat choreiform movements should be included as a potentialextrapulmonary side effect of theophylline.’Stuart AM, et al. Choreiform movements observed in an 8-year-old child followinguse of an oral theophylline preparation. Clinical Pediatrics 31: 692-694, Nov 1992- USA 800171500

» Editorial comment: Acute dyskinesias and choreiformmovements have previously described in infants and childrentreated with aminophylline and theophylline [see Reactions 369:11, 21 Sep 1992 and 412: 4, 1 Aug 1992].

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Reactions 9 Jan 1993 No. 4330114-9954/10/0433-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved