Reactions 1407 - 23 Jun 2012

O STheophylline overdose

Rhabdomyolysis, disseminated intravascularcoagulopathy and other toxicities: case report

A 17-year-old girl developed rhabdomyolysis,disseminated intravascular coagulopathy (DIC) and othertoxicities after taking an overdose of theophylline [Talotren]with suicidal aim.

The girl presented 2 hours after taking approximately52.5g of slow-release theophylline [route not stated].Gastric lavage was carried out, and she received charcoal.She was transferred to an emergency department (ED),where she experienced nausea, vomiting, headache andsleepiness. Her blood theophylline concentration was56.2 µg/mL.

The girl received sodium chloride, repeat doses ofcharcoal, metoclopramide and sodium bicarbonate. ECGindicated supraventricular tachycardia, and metoprolol wasadministered. Twenty-four hours after arriving at the ED,she experienced generalized tonic-clonic seizure activity,after which she received diazepam and was admitted to anICU. Fifteen minutes later, she developed cardiopulmonaryarrest. She was intubated and responded to CPR. Sheexperienced frequent epileptic attacks, and receivedmidazolam and vecuronium bromide. Tests revealedrhabdomyolysis, renal failure and DIC. She receivedhaemodialysis and, on hospital day 9, a blood transfusion.However, on day 10, she developed cardiopulmonaryarrest that did not respond to CPR and died.

Author comment: "It should not be forgotten that insevere [theophylline] intoxications, rhabdomyolysis and DICtable can be developed".Cevik Y, et al. Severe theophylline intoxication, rhabdomyolysis, disseminatedintravascular coagulopathy and death: Case report. Akademik Acil Tip OlguSunumlari Dergisi 1: 24-27, No. 1, 2010. Available from: URL: http://dx.doi.org/10.5505/jaemcr.2011.43153 - Turkey 803072346

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Reactions 23 Jun 2012 No. 14070114-9954/10/1407-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved