Severe metformin intoxication in an adolescent: A case report
Introduction. The frequency of acute metformin intoxication is increasing with increasing availability and accessibility of children and adolescents to this oral antidiabetic. Acute metformin intoxication can be severe and evolve to multiple organ failure. Case report. A 16-year old teenager is tra...
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| Format: | Article |
| Language: | English |
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Amaltea Medical Publishing House
2020-06-01
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| Series: | Romanian Journal of Pediatrics |
| Subjects: | |
| Online Access: | https://rjp.com.ro/articles/2020.2/RJP_2020_2_EN_Art-18.pdf |
| _version_ | 1818590410863280128 |
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| author | Dana Adriana Dascultu Elena Madalina Petran |
| author_facet | Dana Adriana Dascultu Elena Madalina Petran |
| author_sort | Dana Adriana Dascultu |
| collection | DOAJ |
| description | Introduction. The frequency of acute metformin intoxication is increasing with increasing availability and accessibility of children and adolescents to this oral antidiabetic. Acute metformin intoxication can be severe and evolve to multiple organ failure.
Case report. A 16-year old teenager is transfered from another hospital to the Toxicology and Intensive Care unit of ”Grigore Alexandrescu” Emergency Hospital for Children, in Bucharest, for somnolence and vomiting after she has voluntarily taken 10 tablets of Siofor (Metformin). Laboratory findings on admission detected the presence of metabolic acidosis (pH =7.28, EB = -9.4mmol/l, HCO3 = 14.2 mmol/l, lactate = 4.06 mg/dl), and kidney function testes revelead an increased value of creatinine 1.57 mg/dl. Initial treatment included sodium bicarbonate and endovenous glucose and electrolytes without improvment in the clinical status of the patient who evolved with severe lactic acidosis (pH = 7.19, lactate = 5.5 mg/dl, HCO3 = 18 mmo/l), acute renal failure (urea = 59 mg/dl, creatinine = 4.06 mg/dl).
She was transfered to the nephrology unit of another hospital to perform emergency hemodialysis. The patient subsequently underwenth two hemodialysis session, following dialysis normal renal function and full recovery was obtained.
Conclusions. Acute metformin poisoning can be severe and lead to death if unrecognized, monitored and treated rapidly. Lactic acidosis imposes rapid and effective suportive treatment measures or renal replacement therapy |
| first_indexed | 2024-12-16T09:56:06Z |
| format | Article |
| id | doaj.art-87f86a4f21434e309ede1ed2448edd3c |
| institution | Directory Open Access Journal |
| issn | 1454-0398 2069-6175 |
| language | English |
| last_indexed | 2024-12-16T09:56:06Z |
| publishDate | 2020-06-01 |
| publisher | Amaltea Medical Publishing House |
| record_format | Article |
| series | Romanian Journal of Pediatrics |
| spelling | doaj.art-87f86a4f21434e309ede1ed2448edd3c2022-12-21T22:35:55ZengAmaltea Medical Publishing HouseRomanian Journal of Pediatrics1454-03982069-61752020-06-0169217017310.37897/RJP.2020.2.18Severe metformin intoxication in an adolescent: A case reportDana Adriana Dascultu0Elena Madalina Petran1“Grigore Alexandrescu” Emergency Hospital for Children, Bucharest, Romania“Grigore Alexandrescu” Emergency Hospital for Children, Bucharest, RomaniaIntroduction. The frequency of acute metformin intoxication is increasing with increasing availability and accessibility of children and adolescents to this oral antidiabetic. Acute metformin intoxication can be severe and evolve to multiple organ failure. Case report. A 16-year old teenager is transfered from another hospital to the Toxicology and Intensive Care unit of ”Grigore Alexandrescu” Emergency Hospital for Children, in Bucharest, for somnolence and vomiting after she has voluntarily taken 10 tablets of Siofor (Metformin). Laboratory findings on admission detected the presence of metabolic acidosis (pH =7.28, EB = -9.4mmol/l, HCO3 = 14.2 mmol/l, lactate = 4.06 mg/dl), and kidney function testes revelead an increased value of creatinine 1.57 mg/dl. Initial treatment included sodium bicarbonate and endovenous glucose and electrolytes without improvment in the clinical status of the patient who evolved with severe lactic acidosis (pH = 7.19, lactate = 5.5 mg/dl, HCO3 = 18 mmo/l), acute renal failure (urea = 59 mg/dl, creatinine = 4.06 mg/dl). She was transfered to the nephrology unit of another hospital to perform emergency hemodialysis. The patient subsequently underwenth two hemodialysis session, following dialysis normal renal function and full recovery was obtained. Conclusions. Acute metformin poisoning can be severe and lead to death if unrecognized, monitored and treated rapidly. Lactic acidosis imposes rapid and effective suportive treatment measures or renal replacement therapyhttps://rjp.com.ro/articles/2020.2/RJP_2020_2_EN_Art-18.pdfmetforminacute intoxicationteenagerlactic acidosishemodialysis |
| spellingShingle | Dana Adriana Dascultu Elena Madalina Petran Severe metformin intoxication in an adolescent: A case report Romanian Journal of Pediatrics metformin acute intoxication teenager lactic acidosis hemodialysis |
| title | Severe metformin intoxication in an adolescent: A case report |
| title_full | Severe metformin intoxication in an adolescent: A case report |
| title_fullStr | Severe metformin intoxication in an adolescent: A case report |
| title_full_unstemmed | Severe metformin intoxication in an adolescent: A case report |
| title_short | Severe metformin intoxication in an adolescent: A case report |
| title_sort | severe metformin intoxication in an adolescent a case report |
| topic | metformin acute intoxication teenager lactic acidosis hemodialysis |
| url | https://rjp.com.ro/articles/2020.2/RJP_2020_2_EN_Art-18.pdf |
| work_keys_str_mv | AT danaadrianadascultu severemetforminintoxicationinanadolescentacasereport AT elenamadalinapetran severemetforminintoxicationinanadolescentacasereport |