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A Case of Non-traumatic Rhabdomyolysis after Doxylamine Overdose

Journal of the Korean Pediatric Society 2002;45(8):1033-1037.
Published online August 15, 2002.
A Case of Non-traumatic Rhabdomyolysis after Doxylamine Overdose
Sung Woog Hwang1, Hyeung Kyeung No1, Kee Hyuck Kim2
1Department of Pediatrics, College of Medicine, Younsei University, Seoul, Korea
2Department of Pediatrics, National Health Insurance Corporation, Ilsan Hospital, Koyang, Korea
Doxylamine 중독 후 합병한 비 외상성 횡문근융해증 1례
황성욱1, 노현정1, 김기혁2
1연세대학교 의과대학 소아과학교실
2국민건강보험공단 일산병원 소아과
Correspondence: 
Kee Hyuck Kim, Email: kkim@nhimc.or.kr
Abstract
Doxylamine is an antihistamine of the ethanolamine class. It is used primarily as a sleep-inducing agent. Clinicians should be aware of the complications in rhabdomyolysis patients who ingest doxylamine succinate and over-the-counter antihistamines. The easy availability of these substances increases the potential not only of intentional overdose by adults but also of inadvertent ingestion by children. Prompt intervention and careful assessment of renal function, urinary output, and serum creatine kinase levels may represent the difference between an uncomplicated and acute renal failure. Recognition of the potential for rhabdomyolysis and institution of vigorous treatment may prevent acute renal failure in patients who have taken an overdose of the drug. A 14-year-old male was found to have hematuria and oliguria. Evaluation of the patient revealed myoglobinuria, and a creatine kinase(CK) level of 117,563 IU/L. He was recovered by massive fluid administration, urine alkalization and mannitol infusion. We report a case of a suicide attempt in a child where ingestion of the doxylamine complicated by non-traumatic rhabdomyolysis with brief review related literatures.
Key Words: Doxylamine, Rhabdomyolysis


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