Successful management of massive digoxin overdose using DIGIFab and therapeutic plasma exchange: a case report
Abstract Background Despite the efficacy and safety of DIGIFab, it is relatively expensive and has limited availability. In addition, alternative interventions, such as therapeutic plasma exchange, may need to be considered in massive digoxin overdoses. Although few case reports describe its efficac...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2024-03-01
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| Series: | Journal of Medical Case Reports |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13256-024-04386-6 |
| _version_ | 1797274508830179328 |
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| author | Reema M. Alhussein Nawaf A. Alamri Hussain M. Alhashem Mohammed I. Alarifi Bader Alyahya |
| author_facet | Reema M. Alhussein Nawaf A. Alamri Hussain M. Alhashem Mohammed I. Alarifi Bader Alyahya |
| author_sort | Reema M. Alhussein |
| collection | DOAJ |
| description | Abstract Background Despite the efficacy and safety of DIGIFab, it is relatively expensive and has limited availability. In addition, alternative interventions, such as therapeutic plasma exchange, may need to be considered in massive digoxin overdoses. Although few case reports describe its efficacy. Case presentation We report a case of a 17-year-old white male patient brought by family members to our emergency department in Riyadh, Saudi Arabia. After intentionally ingesting 48 mg of digoxin tablets to commit suicide, the patient’s initial digoxin serum level was 8.04 ng/mL. The patient was resuscitated in the emergency department. After admission to the intensive care unit, the patient underwent therapeutic plasma exchange, because of insufficient DIGIFab doses. Afterward, the serum digoxin levels drastically decreased, and his symptoms reverted. The patient was successfully managed and discharged 7 days after admission. Conclusion Despite insufficient evidence and a limited number of case reports describing the use of extracorporeal treatment in digoxin overdose, we noted the significant impact of therapeutic plasma exchange on our patient. However, therapeutic plasma exchange’s use in routine treatment requires stronger evidence to confirm its benefits. |
| first_indexed | 2024-03-07T14:59:24Z |
| format | Article |
| id | doaj.art-63b9bee2605c412dbe0540663faae62e |
| institution | Directory Open Access Journal |
| issn | 1752-1947 |
| language | English |
| last_indexed | 2024-03-07T14:59:24Z |
| publishDate | 2024-03-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Medical Case Reports |
| spelling | doaj.art-63b9bee2605c412dbe0540663faae62e2024-03-05T19:14:39ZengBMCJournal of Medical Case Reports1752-19472024-03-011811610.1186/s13256-024-04386-6Successful management of massive digoxin overdose using DIGIFab and therapeutic plasma exchange: a case reportReema M. Alhussein0Nawaf A. Alamri1Hussain M. Alhashem2Mohammed I. Alarifi3Bader Alyahya4Department of Emergency Medicine, King Saud University, Medical CityDepartment of Emergency Medicine, King Saud University, Medical CityDepartment of Emergency Medicine, King Saud University, Medical CityDepartment of Critical Care Medicine, College of Medicine, King Saud UniversityDepartment of Emergency Medicine, College of Medicine, King Saud UniversityAbstract Background Despite the efficacy and safety of DIGIFab, it is relatively expensive and has limited availability. In addition, alternative interventions, such as therapeutic plasma exchange, may need to be considered in massive digoxin overdoses. Although few case reports describe its efficacy. Case presentation We report a case of a 17-year-old white male patient brought by family members to our emergency department in Riyadh, Saudi Arabia. After intentionally ingesting 48 mg of digoxin tablets to commit suicide, the patient’s initial digoxin serum level was 8.04 ng/mL. The patient was resuscitated in the emergency department. After admission to the intensive care unit, the patient underwent therapeutic plasma exchange, because of insufficient DIGIFab doses. Afterward, the serum digoxin levels drastically decreased, and his symptoms reverted. The patient was successfully managed and discharged 7 days after admission. Conclusion Despite insufficient evidence and a limited number of case reports describing the use of extracorporeal treatment in digoxin overdose, we noted the significant impact of therapeutic plasma exchange on our patient. However, therapeutic plasma exchange’s use in routine treatment requires stronger evidence to confirm its benefits.https://doi.org/10.1186/s13256-024-04386-6DigoxinPlasma exchangeTPEDIGIFabDrug overdoseECTR |
| spellingShingle | Reema M. Alhussein Nawaf A. Alamri Hussain M. Alhashem Mohammed I. Alarifi Bader Alyahya Successful management of massive digoxin overdose using DIGIFab and therapeutic plasma exchange: a case report Journal of Medical Case Reports Digoxin Plasma exchange TPE DIGIFab Drug overdose ECTR |
| title | Successful management of massive digoxin overdose using DIGIFab and therapeutic plasma exchange: a case report |
| title_full | Successful management of massive digoxin overdose using DIGIFab and therapeutic plasma exchange: a case report |
| title_fullStr | Successful management of massive digoxin overdose using DIGIFab and therapeutic plasma exchange: a case report |
| title_full_unstemmed | Successful management of massive digoxin overdose using DIGIFab and therapeutic plasma exchange: a case report |
| title_short | Successful management of massive digoxin overdose using DIGIFab and therapeutic plasma exchange: a case report |
| title_sort | successful management of massive digoxin overdose using digifab and therapeutic plasma exchange a case report |
| topic | Digoxin Plasma exchange TPE DIGIFab Drug overdose ECTR |
| url | https://doi.org/10.1186/s13256-024-04386-6 |
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