Vilela Maria, Fernandes Diana, Salazar Tatiana, Duarte Augusto
Internal Medicine, Centro Hospitalar do Médio Ave, Vila Nova de Famalicão, PRT.
Internal Medicine, Centro Hospitalar Do Médio Ave, Vila Nova de Famalicão, PRT.
Cureus. 2020 Dec 28;12(12):e12333. doi: 10.7759/cureus.12333.
Acute intoxications are common causes of admission to the Emergency Department (ED). Flupirtine is a non-opioid analgesic, originally used for acute and chronic pain. Because of several reports of severe liver toxicity, its use was limited to acute pain in 2013 by the European Medicines Agency. Although withdrawn from the European market in March 2018, there are still flupirtine tablets in many households, and most people are unaware of the hazards they might be facing. A 58-year-old man was admitted to the ED after a suicide attempt with 1 g of flupirtine. He was lethargic and confused but presented no focal neurological deficits or other symptoms, and the rest of his clinical examination was unremarkable. His cerebral CAT and blood chemistry showed no alterations. The only remarkable feature was that he had green urine. After a careful literature search, a similar case was found caused by flupirtine intoxication. After 24 hours of vigilance in the ED, he improved his neurological status and his urine lost part of its greenish color. He was then transferred to the Psychiatric Department, where he presented a complete remission of the clinical alterations. A follow-up check-up showed no permanent deficits.
急性中毒是急诊部（ED）收治患者的常见原因。氟吡汀是一种非阿片类镇痛药，最初用于治疗急慢性疼痛。由于有几例严重肝毒性报告，欧洲药品管理局于2013年将其使用限制于急性疼痛。尽管于2018年3月退出欧洲市场，但许多家庭中仍有氟吡汀片，而且大多数人并未意识到他们可能面临的危害。一名58岁男性在服用1克氟吡汀自杀未遂后被送往急诊部。他嗜睡且神志不清，但未出现局灶性神经功能缺损或其他症状，其余临床检查无异常。他的脑部计算机断层扫描（CAT）和血液生化检查均无改变。唯一显著的特征是他的尿液呈绿色。经过仔细的文献检索，发现了一例由氟吡汀中毒引起的类似病例。在急诊部密切观察24小时后，他的神经状态有所改善，尿液的绿色也褪去了一部分。随后他被转至精神科，在那里他的临床症状完全缓解。随访检查未发现永久性缺损。
