Eshleman S H, Shaw L M
Department of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania, Philadelphia 19104.
Clin Chem. 1990 Feb;36(2):398-9.
We report a case of fatal theophylline overdose in a 16-year-old asthmatic boy who presented with seizures, respiratory arrest, and a theophylline concentration of 117 mg/L in serum. His hospital course was complicated by refractory hypotension and severe ischemic necrosis of skeletal muscle, bowel, and liver. The metabolic abnormalities observed early in his hospital course included severe hyperkalemia, hyperphosphatemia, hypermagnesemia, hypocalcemia, and profound metabolic acidosis. These metabolic abnormalities differ from those previously reported in cases of massive theophylline overdose. The metabolic abnormalities observed in this patient probably reflected his extensive ischemic tissue damage with release of intracellular ions and associated acidemia. Markedly increased catalytic activities of creatine kinase, aspartate aminotransferase, and alanine aminotransferase in serum were also noted.
我们报告一例16岁哮喘男孩因茶碱过量致死的病例，该男孩出现癫痫发作、呼吸骤停，血清茶碱浓度为117mg/L。其住院过程因难治性低血压以及骨骼肌、肠道和肝脏的严重缺血性坏死而复杂化。在其住院早期观察到的代谢异常包括严重高钾血症、高磷血症、高镁血症、低钙血症以及严重代谢性酸中毒。这些代谢异常与先前报道的大量茶碱过量病例不同。该患者观察到的代谢异常可能反映了其广泛的缺血性组织损伤伴细胞内离子释放及相关酸血症。血清中肌酸激酶、天冬氨酸氨基转移酶和丙氨酸氨基转移酶的催化活性也显著增加。
