Department of Intensive Medicine, The First Affiliated Hospital of Fujian Medical University, No.20, Chazhong Road, Taijiang District, Fuzhou, Fujian 350005, China; The First School of Clinical Medicine, Fujian Medical University, No.20, Chazhong Road, Taijiang District, Fuzhou, Fujian 350005, China.
Shengli Clinical Medical College, Fujian Medical University, No.134, East Street, Gulou District, Fuzhou 350000, Fujian, China; Department of Gastroenterology, Fujian Provincial Hospital South Branch, No. 516, South Jinrong Road, Cangshan District, Fuzhou 350000, Fujian, China.
Am J Emerg Med. 2022 Jul;57:236.e1-236.e3. doi: 10.1016/j.ajem.2022.04.010. Epub 2022 Apr 13.
Chlorpheniramine is an H1 receptor antagonist of the alkylamine class. It is a widely used anti-allergy drug due to its strong antihistamine effect and mild adverse effects. In the case of chlorpheniramine overdose or poisoning, the primary manifestation is central nervous system symptoms. To date, no case of rhabdomyolysis induced by acute poisoning with chlorpheniramine has ever been reported. This study reports a case of acute chlorpheniramine poisoning at an oral dose of 4000 mg, which is the highest reported poisoning dose to date. The diagnosis of rhabdomyolysis (creatine kinase, 195,489 U/L) and acute kidney injury (serum creatinine, 150.1 umol/L) was confirmed based on laboratory results. After haemoperfusion and continuous renal replacement therapy, the patient's renal function fully recovered. This paper aims to analyse the clinical data of this patient and summarize its clinical characteristics. At the same time, the mechanism of chlorpheniramine-induced rhabdomyolysis is also explored in the context of the literature review.
氯苯那敏是一种烷基胺类 H1 受体拮抗剂。由于其具有较强的抗组胺作用和较轻的不良反应，因此被广泛用作抗过敏药物。在氯苯那敏过量或中毒的情况下，主要表现为中枢神经系统症状。迄今为止，尚未有报道过因急性氯苯那敏中毒引起横纹肌溶解的病例。本研究报告了一例口服氯苯那敏 4000 毫克的急性中毒病例，这是迄今为止报告的最高中毒剂量。根据实验室结果，诊断为横纹肌溶解症（肌酸激酶，195489 U/L）和急性肾损伤（血清肌酐，150.1 μmol/L）。经过血液灌流和连续性肾脏替代治疗，患者的肾功能完全恢复。本文旨在分析该患者的临床资料并总结其临床特征。同时，还结合文献复习探讨了氯苯那敏引起横纹肌溶解的机制。
