Saitoh Y, Bando T, Kanamori K, Mifune J, Sasaki F, Ishizaki T, Miyabo S
Department of Respiratory Disease, Fukui Circulation Center, Japan.
Nihon Kyobu Shikkan Gakkai Zasshi. 1992 Dec;30(12):2118-22.
A 70-year-old woman was hospitalized for status asthmaticus. The level of CRP was high and chest roentgenogram showed infiltrative shadows in the left middle lung field. Artificial respiration and continuous infusion of methylprednisolone and aminophylline 750 mg/24 hr were performed. Eight hours after admission, seizures suddenly occurred. At this time, brain CT showed no abnormal findings. The seizures were thought to be induced by theophylline toxicity, since serum theophylline concentration was high at 69.9 micrograms/ml. Because theophylline clearance of the patient in a clinically stable condition was normal, it was speculated that theophylline clearance was reduced during status asthmaticus. It is thought that this rare case of theophylline toxicity occurred due to reduction of theophylline clearance during status asthmaticus associated with pneumonia.
一名70岁女性因哮喘持续状态入院。CRP水平升高,胸部X线片显示左中肺野有浸润性阴影。进行了人工呼吸,并持续静脉输注甲泼尼龙和氨茶碱,剂量为750毫克/24小时。入院8小时后突然发生惊厥。此时,脑部CT未发现异常。考虑惊厥是由茶碱中毒引起的,因为血清茶碱浓度高达69.9微克/毫升。由于患者在临床稳定状态下的茶碱清除率正常,推测在哮喘持续状态期间茶碱清除率降低。认为这例罕见的茶碱中毒病例是由于哮喘持续状态合并肺炎期间茶碱清除率降低所致。