Kocaeli University, Faculty of Medicine, Dept. of Emergency Medicine, Kocaeli, Turkey.
Kocaeli University, Faculty of Medicine, Dept. of Emergency Medicine, Kocaeli, Turkey.
Am J Emerg Med. 2018 Jun;36(6):1125.e3-1125.e5. doi: 10.1016/j.ajem.2018.03.022. Epub 2018 Mar 13.
Alpha lipoic acid (ALA) is a potent antioxidant used to treat a variety of disorders. Although ALA is considered a very safe supplement and intoxication is very rare, acute high-dose ingestions can cause mortality. In this report, we discuss a very rare case of ALA intoxication to increase awareness of this issue.
A 22-year-old female was referred to our emergency department with ALA intoxication after ingesting a total of 18g of ALA with a suicidal intention. The patient was found in an altered mental state and confused. During the physical examination, the patient's Glasgow Coma Scale was 13 (E4M6V3); however, she was neither alert nor oriented. Vital signs revealed a mildly decreased blood pressure, tachycardia, and an increased respiratory rate. Cranial nerve examination was normal except a horizontal gaze nystagmus. Laboratory testing showed a decompensated metabolic acidosis. T wave inversions were seen in the electrocardiography (EKG). The patient was treated with supportive treatment and discharged within three days of intensive care unit (ICU) admission.
ALA is a very common supplement that is easily accessible worldwide. Although ALA intoxication is very rare, it is sometimes seen after accidental or suicidal acute ingestion. Neurologic effects, metabolic acidosis, and t wave inversions in the EKG are observed when this acute poisoning occurs. Supportive treatment should be the main therapy.
硫辛酸（ALA）是一种有效的抗氧化剂，用于治疗多种疾病。尽管 ALA 被认为是一种非常安全的补充剂，中毒非常罕见，但急性大剂量摄入可导致死亡。在本报告中，我们讨论了一例非常罕见的 ALA 中毒病例，以提高对此问题的认识。
一名 22 岁女性因有自杀意念而总共摄入 18 克 ALA 后被转至我们的急诊部，被诊断为 ALA 中毒。患者被发现处于神志改变和意识模糊状态。在体格检查中，患者的格拉斯哥昏迷量表评分为 13 分（E4M6V3）；但患者既不清醒也没有定向力。生命体征显示血压轻度下降、心动过速和呼吸频率增加。除水平性眼球震颤外，颅神经检查正常。实验室检查显示失代偿性代谢性酸中毒。心电图（EKG）显示 T 波倒置。患者接受了支持性治疗，并在入住重症监护病房（ICU）三天内出院。
ALA 是一种非常常见的补充剂，在全球范围内都很容易获得。尽管 ALA 中毒非常罕见，但在意外或自杀性急性摄入后有时会发生。当发生这种急性中毒时，会观察到神经效应、代谢性酸中毒和 EKG 中的 T 波倒置。支持性治疗应是主要治疗方法。
