Theophylline overdose Metabolic abnormalities

To determine the frequency and severity of metabolic abnormalities associated with intentional theophylline overdose, laboratory data from 22 cases of theophylline poisoning were retrospectively reviewed. Hypokalaemla was present in all patients and correlated negatively with serum IheophyUine. Serum glucose was elevated in all but 2 patients In 17 patients there was a progressive decline of serum glucose as serum theophylline levels decreased. No patient had a history of diabetes mellitus before admission. The admission leucocyte count was elevated in 11 of 19 patients. A significant correlation was apparent between the leucocyte levels and simultaneous serum theophylline determinations. The mechanism responsible for this increase in circulating leucocytes is unclear but may be secondary to a theophylline-induced increase in plasma catecholamines, which is known to promote demarginatlon of leueoeyles, 12 of 15 patients had respiratory alkalosis which was probably the result of the central respiratory stimulant effects of theophylline. As these metabolic abnormalities', . , may contribute to the cardiovascular and neurologic toxicities of theophylline. , , it is important that their association with theophylline toxicity be recognized.' Ha", KW et al· Annals of Internal Medicine 101 451 (OCI 1984)

0157-7271/84/1110-0009/0$01.00/0 @ADIS Press Reactions 10 Nov 1984 9