Theophylline overdose Lactic acidosis: case report 00

An 18-year-old man took 9g of con trolled-release theophylline in a suicide attempt. On admission 2 hours later, sinus tachycardia was present; serum theophylline concentration was 8 mg/L.

Ipecac, magnesium citrate and activated charcoal were administered but over the next 12 hours, theophylline concentration increased to 83 mg/L. HR was increased and the patient developed hyperglycaemia and increased anion gap metabolic acidosis.

Arterial blood gas analysis revealed a slight decrease in pH , increased oxygen tension and decreased carbon dioxide tension. Bicarbonate was 13 mEq/L and serum lactate level was elevated at 52 mg/dl.

Because of the profound hyperadrenergic state, charcoal haemoperfusion was performed for 90 min . Tachycardia and metabolic acidosis improved and theophylline concentration had decreased to zero within 10 hours. Metabolic status was normal the following day.

This case ' ___ substantiates the role of lactate accumulation in the metabolic acidosis associated with isolated theophylline toxicity '_

Leventhal LJ. Kochar G. Feldman NH. Podolsky SM. Stanek MS. Lactic acidosIs In theophylline overdose. American Journal of Emergency Medicine 7: 417-418. Jul 1989 38<