PROLONGED INTERMITTENT KIDNEY REPLACEMENT THERAPY IN ACUTE THEOPHYLLINE INTOXICATION: A CASE REPORT AND REVIEW OF LITERATURE

Document Type : Case Reports

Authors

1 Internal Medicine department, Clinical nephrology, Haemodialysis and Transplantation Unit, Faculty of medicine, Menofia University, Menofia, Egypt

2 Forensic Medicine and Clinical Toxicology department, Faculty of Medicine, Menofia University, Menofia, Egypt

3 Intensive care department, Faculty of medicine, Menofia University, Menofia, Egypt

4 Nasser institute for research and treatment, Cairo, Egypt

5 Forensic Medicine & Clinical Toxicology Department, faculty of Medicine, Menoufia University

Abstract

Background: Like caffeine, theophylline is a methylxanthine chemical obtained from plants that is used to treat various diseases. It is considered to be the main treatment for asthma. Being widely available, it is widely used for suicidal attempts by adolescents or adults, producing acute intoxication. A wide range of clinical and metabolic disorders, including mortality, are frequently the outcome of theophylline intoxication. Theophylline has a small volume of distribution and is efficiently removed by extracorporeal elimination (haemodialysis or charcoal hemoperfusion). Prolonged Intermittent Kidney Replacement Therapy (PIKRT) is a term describing a hybrid form of KRT (Kidney Replacement Therapy), which provides clearance for a time that is significantly longer than a typical haemodialysis session, which lasts three to four hours, but not twenty-four hours like continuous kidney replacement therapy (CKRT). Case Presentation: Here we present a case of 18 year old female patient from Menofia with severe suicidal theophylline toxicity using a fatal dose of theophylline and presenting to us with shock, seizures, arrhythmia, severe metabolic acidosis and electrolyte disturbances, which was treated successfully with PIKRT. Conclusion: The current case presentation confirms that PIKRT is an effective therapy in treatment of severe theophylline toxicity.

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