ABSTRACT
Doxylamine succinate is common over-the-counter sleep medication that is frequently involved in accidental poisonings and suicide attempts. Doxylamine overdose is generally directed at the anticholinergic effect including autonomic,and central nervous system effect and direct cardiac toxicity. Rarely, rhabdomyolysis has been reported with doxylamine overdose. We experienced two cases of rhabdomyolysis with overdose of doxylamine in 17-year-old and 31-year-old male. They were diagnosed with high levels of creatine phosphokinase in serum, myoglobin in serum and urine, and increased radionuclide uptake of muscles in (99m)Tc-MDP bone scan. Patients recovered without any complications with hydration and diuresis. Clinicians should be aware of the possibility of rhabdomyolysis in patients with doxylamine overdose.
Subject(s)
Adolescent , Adult , Humans , Male , Acute Kidney Injury , Central Nervous System , Creatine Kinase , Diuresis , Doxylamine , Muscles , Myoglobin , Poisoning , Rhabdomyolysis , Succinic Acid , SuicideABSTRACT
Phenylpropanolamine is a sympathomimetic amine used widely as a decongestant or appetite suppressant. Reports of the myocardial injury from the use of phenylpropanolamine are rare and the mechanism of the myocardial injury is not known clearly. We experienced a case of myocardial injury after ingestion of phenyl-propanolamine. A 46-year-old woman was admitted because of chest pain and dyspnea after ingestion of 5 tablets of anorectic pill containing phenylpropanolamine 75 mg per tablet. The serum creatine kinase MB isoenzyme levels were elevated and electrocardiographic abnormalities suggesting myocardial infarction were seen in the precordial lead. In echocardiograpy, left ventricular anteroseptal wall motion was nearly akinetic but coronary angiography showed normal coronary arteries except sluggish blood flow in left anterior descending artery.
Subject(s)
Female , Humans , Middle Aged , Appetite , Arteries , Chest Pain , Coronary Angiography , Coronary Vessels , Creatine Kinase , Dyspnea , Eating , Electrocardiography , Myocardial Infarction , Phenylpropanolamine , TabletsABSTRACT
Sevral cases of acute renal failure and acute hepatitis after ingestion of raw carp gall bladder have been reported. We experienced for the first time 1 case of acute renal failure and acute hepatitis associated with rhabdomyolysis, which has not been seen in previous studies, after ingestion of the raw carp gall bladder. Serum creatine phosphokinase, myoglobin and urine myoglobin were increased and 99mTc-MDP bone scan showed diffusely increased uptake of isotope in soft tissue of whole body. The other laboratory data corresponded to acute tubular necrosis and acute toxic hepatitis. The kidney pathology showed the recovery phase of acute tubular necrosis. Etiologic factor for rhabdomyolysis was not found except carp gall bladder. We considered that carp gall bladder was etiologic factor for rhabdomyolysis and that rhabdomyolysis acted as agravatting factor for developing acute tubular necrosis due to carp bile toxicity in this case.