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In acute theophylline poisoning hypokalaemia, hyperglycaemia, and other electrolyte disturbances may occur. These abnormalities have been attributed to catecholamine excess with intracellular movement of potassium and catecholamine-stimulated gluconeogenesis. Herein we describe a female teenager, who developed metabolic disturbances with significant toxic response to oral theophylline overdose in a suicide attempt. Severe hypokalaemia (1.8 mmol/L) was among the leading pathological findings, at peak theophylline concentration (68 mg/L). There was high plasma glucose (10.2 mmol/L). Creatinine-kinase was evidently abnormal (8.60 microkat/L) several hours post poisoning, while serum myoglobin was markedly elevated (74.8 microg/L) despite the decrease in the drug level. Ventricular arrhythmia with marked extra systoles has been confirmed on electrocardiograph. Finally, the patient recovered through intensive care management with theophylline level (21.1 mg/L) falling close to reference range after 48 hours, but relative hypokalaemia persisted despite potassium supplementations even after the drug level fall below detection limit. In conclusion, timely gastrointestinal decontamination, determination of serum drug levels in intervals, electrocardiography evaluation followed by treatment of arrhythmias, supportive care including balancing of metabolic disturbances, follow-up assessment of serum electrolytes, in particular potassium and creatinine-kinase parallel with myoglobin level assessment even after significant decrease in theophylline level are very important measures.

MeSH
hypokalemie chemicky indukované terapie MeSH
lidé MeSH
mladiství MeSH
pokus o sebevraždu * MeSH
theofylin otrava MeSH
Check Tag
lidé MeSH
mladiství MeSH
ženské pohlaví MeSH
Publikační typ
anglický abstrakt MeSH
časopisecké články MeSH
kazuistiky MeSH
Názvy látek
theofylin MeSH

Článek

Zdravotni aspekty péce o dospivajici
[Health aspects of the adolescent care]

Rubín, A
Autor Rubín, A

Casopis lekaru ceskych. 1971 Nov 12 ; 110 (46) : 1083-5.

Cas Lek Cesk
ISSN 0008-7335
Zdroj

Článek

Mimorádné výhody pro dĕti a dospívající tĕzce postizené na zdraví
[Special financial assistance for children and adolescents with severe handicaps]

Höllge, J
Autor Höllge, J

Ceskoslovenska pediatrie. 1980 Oct ; 35 (10) : 566-8.

Cesk Pediatr
ISSN 0069-2328
Zdroj

Článek

Význam pravidelnĕ opakovaného screeningu genitální chlamydiózy u dospívající mládeze
[Importance of regular screening for genital chlamydiosis in adolescents]

Ceska gynekologie. 2003 Mar ; 68 (2) : 68-71.

Ceska Gynekol
ISSN 1210-7832
Zdroj

OBJECTIVE: Determination of prevalence of genital chlamydiosis in similar group of adolescents as in that examined two years ago. Comparison of the results with the previous ones to confirm positive impact of a repeated screening on drop of prevalence of the infection. Another objective is to make the epidemiological data on genital chlamydiosis in the countries of the "Eastern Block" more accurate, and at the same time to assess the most suitable screening method. DESIGN: Prospective epidemiological study aimed at finding whether the repeated screening examinations of genital chlamydiosis in adolescents will result in decreased incidence of the infection. SETTING: Veterinary Research Institute, Department of Clinical Microbiology of the Faculty Hospital, Regional Hygienic Station, Department of Gynecology and Obstetrics, Medical Faculty, Masaryk University, Brno. METHODS: The groups under testing comprised male and female students of two secondary medical schools and one private grammar school older than 18 (n = 232, of which 33 were boys and 199 girls). Direct detection of C. trachomatis was carried out from the urinary sediment of the sample of morning urine using ligase reaction, polymerase chain reaction, ELISA and direct immunofluorescence. RESULTS: Identical positive result of C. trachomatis detection by four methods was obtained 4 times, i.e. 1.7%. The result of LCR and PCR were positive identically (4 times), ELISA and IF were, besides the above results, positive in other 1 resp. 5 cases. CONCLUSION: Screening examinations of genital chlamydiosis were performed in adolescents in the town of Brno. Morning samples of urine from 232 students of secondary schools were examined on C. trachomatis using the following methods: LCR, PCR, ELISA, and IF. The LCR and PCR were positive 4 times, ELISA 5 times, IF 9 times. Positive results by LCR and PCR were identical. ELISA and IF were positive in other cases. Noninvasive methods are suitable for screening of latent genital chlamydiosis and for estimation of its prevalence. The authors of the study recommend the ligase chain reaction (LCR) as a most suitable screening method.