Acute theophylline intoxication – Case report
Authors:
Májek Milan 1; Volnárová Alena 2; Hollá Zuzana 3; Lichvárová Ildikó 2; Valaška Pavol 2
Authors‘ workplace:
Klinika anestéziológie a intenzívnej medicíny, NsP akad. L. Dérera, Bratislava
1; Oddelenie anestéziológie a intenzívnej medicíny, Nemocničná, a. s., Malacky
2; Hemodialyzačné oddelenie, Nemocničná a. s., Malacky
3
Published in:
Anest. intenziv. Med., 19, 2008, č. 4, s. 197-202
Category:
Intesive Care Medicine - Case Report
Overview
A case report of acute theophylline overdose in a mentally retarded patient is presented. Due to alterations of consciousness, no relevant data enabling a potential diagnosis of theophylline intoxication could be obtained either from the patient or from his family. Considering methanol and ethylenglycol intoxication, toxicologic analysis was realized, that finally revealed a severe theophylline intoxication, consistent with both clinical and biochemical status. Clinical symptoms and biochemical findings of the patient are then analysed from the pathophysiological point of view. Acute renal failure and septic pulmonary infection occurred as a complication, requiring artificial ventilation and urgent hemodialysis. Patient was transferred to internal department on day 32 in a good clinical condition.
Key words:
theophylline – intoxication – clinical intoxication symptoms – theophylline intoxication therapy
Sources
1. Reilly, T. H., Holstege, C. P. Toxicity, Theophylline. August 2006. Dostupné na: www.emedicine.com/ped/topic2725.
2. Dawson, A. H., Whyte, I. M. The assessment and treatment of theophylline poisoning. Med. J., 1989, 151, p. 689–693.
3. Shannon, M. Predictors of major toxicity after theophylline overdose. Ann. Intern. Med., 1993, 119, p. 1161–1167.
4. Anderson, W., Youl, B., Mackay, I. R. Acute theophylline intoxication. Ann. Emerg. Med., 1991, 20, p. 1143–1145.
5. Dzúrik, R., Dzúriková, V., Fedelešová,V. Poruchy vnútorného prostredia. Osveta : Martin 1984, 253 s.
6. Shannon, M. Hypokaliemia, hyperglykemia and plasma catecholamine activity after severe theophylline intoxication. Clin. Toxikol., 1994, 32, p. 41–47.
7. Teweleit, S., Hippius, M., Pfeifer, R., Hoffmann, A. Rhabdomyolysis as a rare complication of theophylline poisoning. Medizinische Klinik (Munich, Germany), 2001, 96, p. 40–44.
8. Charyton, D., Jansen., K. Severe metabolic complications from theophylline intoxication. Nephrology (Carlton), 2003, 8, p. 239–242.
9. Bernard, S. Severe lactic acidosis following theophylline overdose. Ann. Emerg. Med., 1991, 20, p. 1135–1137.
10. Madias, N. E., Goorno, W. E., Herson, S. Severe lactic acidosis as a presenting feature of pheochromocytoma. Am. J. Kidney Dis., 1987, 102, p. 250–253.
11. Kearney, T. E., Ziegler, M. G. Theophylline toxicity and the beta-adrenergic system. Ann. Intern. Med., 1985, 102, p. 766–769.
12. Moss, J., Glick, D. The autonomic nervous system. In: Miller, R. D. Miller’s anesthesia. Philadephia: Elsevier Churchil Livingstone, 2005, p. 617–677. ISBN 9997629035.
13. Shannon, M. Life-threating events after theofylline overdose. A 10-year prospective analysis. Arch. Intern. Med., 1999, 159, p. 989–994.
Labels
Anaesthesiology, Resuscitation and Inten Intensive Care MedicineArticle was published in
Anaesthesiology and Intensive Care Medicine
2008 Issue 4
Most read in this issue
- Acute disseminated encephalomyelitis (ADEM) – Case Report
- Antimicrobial protection options in central venous catheters – Overview
- Acute theophylline intoxication – Case report
- Treatment of acute heart failure syndrome – review