Severe theophylline poisoning treated with continuous venovenous hemodialysis in a child

Theophylline poisoning generally occurs due to acute high dose intake as well as chronic intake of the medication. Toxicity symptoms can be seen with a plasma concentration of theophylline over 20 μg/ml. The consequences of theophylline toxicity include metabolic disturbances (hypokalemia, hy...

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Main Authors: Ayhan Yaman, Tanıl Kendirli, Çağlar Ödek, Ebru Azapağası, Hatice Erkol, İbrahim Etem Pişkin, Serap Teber-Tıraş, Fatoş Yalçınkaya
Format: Article
Language:English
Published: Hacettepe University Institute of Child Health 2016-06-01
Series:The Turkish Journal of Pediatrics
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Online Access:https://turkjpediatr.org/article/view/1114
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author Ayhan Yaman
Tanıl Kendirli
Çağlar Ödek
Ebru Azapağası
Hatice Erkol
İbrahim Etem Pişkin
Serap Teber-Tıraş
Fatoş Yalçınkaya
author_facet Ayhan Yaman
Tanıl Kendirli
Çağlar Ödek
Ebru Azapağası
Hatice Erkol
İbrahim Etem Pişkin
Serap Teber-Tıraş
Fatoş Yalçınkaya
author_sort Ayhan Yaman
collection DOAJ
description Theophylline poisoning generally occurs due to acute high dose intake as well as chronic intake of the medication. Toxicity symptoms can be seen with a plasma concentration of theophylline over 20 μg/ml. The consequences of theophylline toxicity include metabolic disturbances (hypokalemia, hyperglycemia, and metabolic acidosis), nausea, vomiting, and in severe cases seizures, cardiac arrhythmias, and death. Theophylline poisoning in children is rarely described in the literature. A 3-year-old girl was referred from another hospital to our pediatric intensive care unit (PICU) due to prolonged refractory status epilepticus and respiratory failure linked with severe theophylline poisoning. The patient was admitted to our PICU 24 hours after the patient took theophylline. The referring center could not measure the serum theophylline level. The patient's first serum theophylline level that was checked at admission was 54 μg/ml. We started continuous venovenous hemodialysis (CVVHD) 3 hours after PICU admission and the patient's theophylline level successfully decreased within 9 hours. The patient was discharged at the 40th day of admission from our hospital with severe neurological disability. In conclusion, severe theophylline poisoning may be seen in children. We must consider CVVHD in critically ill children with severe theophylline poisoning.
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publishDate 2016-06-01
publisher Hacettepe University Institute of Child Health
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spelling doaj-art-5081691b3c4d488ab746d9dfba2e8c4d2025-08-20T03:00:53ZengHacettepe University Institute of Child HealthThe Turkish Journal of Pediatrics0041-43012791-64212016-06-0158310.24953/turkjped.2016.03.011Severe theophylline poisoning treated with continuous venovenous hemodialysis in a childAyhan Yaman0Tanıl Kendirli1Çağlar Ödek2Ebru Azapağası3Hatice Erkol4İbrahim Etem Pişkin5Serap Teber-Tıraş6Fatoş Yalçınkaya7Divisions of Pediatric Intensive Care, Ankara University Faculty of Medicine; Ankara, Turkey.Divisions of Pediatric Intensive Care, Ankara University Faculty of Medicine; Ankara, Turkey.Divisions of Pediatric Intensive Care, Ankara University Faculty of Medicine; Ankara, Turkey.Divisions of Pediatric Intensive Care, Ankara University Faculty of Medicine; Ankara, Turkey.Department of Pediatrics, Ankara University Faculty of Medicine; Ankara, Turkey.Department of Pediatrics, Bülent Ecevit University Faculty of Medicine, Zonguldak, Turkey.Divisions of Pediatric Neurology, Ankara University Faculty of Medicine; Ankara, Turkey.Divisions of Pediatric Nephrology, Ankara University Faculty of Medicine; Ankara, Turkey. Theophylline poisoning generally occurs due to acute high dose intake as well as chronic intake of the medication. Toxicity symptoms can be seen with a plasma concentration of theophylline over 20 μg/ml. The consequences of theophylline toxicity include metabolic disturbances (hypokalemia, hyperglycemia, and metabolic acidosis), nausea, vomiting, and in severe cases seizures, cardiac arrhythmias, and death. Theophylline poisoning in children is rarely described in the literature. A 3-year-old girl was referred from another hospital to our pediatric intensive care unit (PICU) due to prolonged refractory status epilepticus and respiratory failure linked with severe theophylline poisoning. The patient was admitted to our PICU 24 hours after the patient took theophylline. The referring center could not measure the serum theophylline level. The patient's first serum theophylline level that was checked at admission was 54 μg/ml. We started continuous venovenous hemodialysis (CVVHD) 3 hours after PICU admission and the patient's theophylline level successfully decreased within 9 hours. The patient was discharged at the 40th day of admission from our hospital with severe neurological disability. In conclusion, severe theophylline poisoning may be seen in children. We must consider CVVHD in critically ill children with severe theophylline poisoning. https://turkjpediatr.org/article/view/1114childrencontinuous venovenous hemodialysispediatric intensive care unitseizurestheophylline poisoning
spellingShingle Ayhan Yaman
Tanıl Kendirli
Çağlar Ödek
Ebru Azapağası
Hatice Erkol
İbrahim Etem Pişkin
Serap Teber-Tıraş
Fatoş Yalçınkaya
Severe theophylline poisoning treated with continuous venovenous hemodialysis in a child
The Turkish Journal of Pediatrics
children
continuous venovenous hemodialysis
pediatric intensive care unit
seizures
theophylline poisoning
title Severe theophylline poisoning treated with continuous venovenous hemodialysis in a child
title_full Severe theophylline poisoning treated with continuous venovenous hemodialysis in a child
title_fullStr Severe theophylline poisoning treated with continuous venovenous hemodialysis in a child
title_full_unstemmed Severe theophylline poisoning treated with continuous venovenous hemodialysis in a child
title_short Severe theophylline poisoning treated with continuous venovenous hemodialysis in a child
title_sort severe theophylline poisoning treated with continuous venovenous hemodialysis in a child
topic children
continuous venovenous hemodialysis
pediatric intensive care unit
seizures
theophylline poisoning
url https://turkjpediatr.org/article/view/1114
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AT caglarodek severetheophyllinepoisoningtreatedwithcontinuousvenovenoushemodialysisinachild
AT ebruazapagası severetheophyllinepoisoningtreatedwithcontinuousvenovenoushemodialysisinachild
AT haticeerkol severetheophyllinepoisoningtreatedwithcontinuousvenovenoushemodialysisinachild
AT ibrahimetempiskin severetheophyllinepoisoningtreatedwithcontinuousvenovenoushemodialysisinachild
AT seraptebertıras severetheophyllinepoisoningtreatedwithcontinuousvenovenoushemodialysisinachild
AT fatosyalcınkaya severetheophyllinepoisoningtreatedwithcontinuousvenovenoushemodialysisinachild