Yokoyama Koji, Kaizaki-Mitsumoto Asuka, Numazawa Satoshi, Mamada Mitsukazu
Department of Pediatrics, Japanese Red Cross Wakayama Medical Center, Wakayama, JPN.
Department of Toxicology, Showa University Graduate School of Pharmacy, Tokyo, JPN.
Cureus. 2024 Jun 30;16(6):e63540. doi: 10.7759/cureus.63540. eCollection 2024 Jun.
Diphenhydramine is a first-generation antihistamine medication. Acute intoxication with diphenhydramine can be severe and potentially fatal. The current case is of a 13-year-old girl who presented with central nervous system depression after voluntary intake of unknown drugs. Serum concentration analysis showed diphenhydramine intoxication, blood half-life extension, and a false positive result for tricyclic antidepressants (TCAs) in urine examination. To our knowledge, this is the first reported case of confirmed diphenhydramine overdose with a false positive result for TCAs and measurement of the serum level in a child. Considering the similarities between the clinical symptoms of diphenhydramine and TCA intoxication, this case illustrates that all physicians should consider the possibility of cross-reactivity during the diagnosis of patients with unknown acute drug intoxication who test positive for TCAs.
苯海拉明是一种第一代抗组胺药物。苯海拉明急性中毒可能很严重，甚至有潜在致命风险。本病例为一名13岁女孩，在自愿服用未知药物后出现中枢神经系统抑制。血清浓度分析显示苯海拉明中毒、血液半衰期延长，且尿液检查中三环类抗抑郁药（TCA）出现假阳性结果。据我们所知，这是首例报告的确诊苯海拉明过量且TCA出现假阳性结果以及对儿童进行血清水平测定的病例。鉴于苯海拉明和TCA中毒临床症状相似，该病例表明，所有医生在诊断TCA检测呈阳性的不明急性药物中毒患者时，都应考虑交叉反应的可能性。
