Department of Paediatrics, Alliance Hospital, Abuja; Faculty of Paediatrics, National Postgraduate Medical College of Nigeria, Lagos, Nigeria; Department of Maternal and Child Health, School of Public Health, James Lind Institute, Geneva, Switzerland.
Department of Psychiatry, Federal Medical Centre, Keffi, Nasarawa State, Nigeria.
Ann Afr Med. 2023 Jul-Sep;22(3):392-394. doi: 10.4103/aam.aam_28_22.
Caffeine, a popular over-the-counter methylxanthine, is widely consumed for its potent psychoactive properties. Toxicity generally occurs with intentional overdose and is often multisystemic and life-threatening. Consumption by children is rarely planned, and safe doses are potentially toxic in them. A 12-year-old boy whose parents had denied him coffee on several occasions eventually had access to it. The caffeine dose ingested was sub-toxic although he developed severe and life-threatening multisystemic caffeinism. Following ingestion, he became aggressive and was talking irrationally, with visual and auditory hallucinations. In addition, he had severe abdominal pain, multiple vomiting episodes, circulatory collapse, hypertension, angioedema, dysfunctional tear syndrome, hyperglycemia, ketonuria, hypokalemia, and metabolic acidosis. The clinical presentation, laboratory findings, and interventions are reviewed and discussed. Besides routine immunization, routine anticipatory guidance should be at the center of preventive pediatrics. Packaging of caffeinated beverages should also target the prevention of caffeine toxicity in children.
咖啡因是一种常见的非处方甲基黄嘌呤，因其具有强烈的精神活性而被广泛消费。毒性通常发生在故意过量摄入时，且常常是多系统的并危及生命。儿童的摄入量通常不是故意的，而且对他们来说，安全剂量可能是有毒的。一个 12 岁的男孩，他的父母曾多次拒绝给他咖啡，最终他得到了咖啡。他摄入的咖啡因剂量虽然低于中毒剂量，但却患上了严重且危及生命的多系统咖啡因中毒。摄入后，他变得具有攻击性，说话不合理，出现视觉和听觉幻觉。此外，他还出现严重腹痛、多次呕吐、循环衰竭、高血压、血管性水肿、泪液分泌功能障碍、高血糖、酮尿、低钾血症和代谢性酸中毒。本文回顾并讨论了临床表现、实验室发现和干预措施。除了常规免疫接种外，常规预期指导也应成为预防儿科的核心。含咖啡因饮料的包装也应针对预防儿童咖啡因中毒。
