A 16-year-old male presenting with anticholinergic symptoms was found to have hematuria and oliguria. Evaluation of the patient revealed a serum creatinine of 2.2 mg/d1, myoglobinuria, and a creatine phosphokinase (CPK) level of 78, 750 IU/1 with 99 percent fraction 3 isoenzyme. A toxic screen showed the presence of doxylamine, an antihistamine of the ethanolamine class, at a level of 75 times therapeutic. The patient did not have a history of trauma or seizures. The extremely high CPK level with the doxylamine overdose suggests that doxylamine may be associated with nontraumatic rhabdomyolysis. This is the first case report of rhabdomyolysis being associated with an antihistamine overdose.
Get full access to this article
View all access options for this article.
References
1.
Pascoe D., Grossman M., et al. PediatricEmergencies. 2nd ed., Philadelphia : J.B. Lippincott, 1978:95-7.
2.
Haapanen E., Pellinen J., Partanen J.Acute renal failure caused by alcohol-induced rhabdomyolysis. Nephron1984;36:191-3.
3.
Chesson A., Kasarskis E., Small U.Postictal elevation of serum creatine kinase level. Arch Neurol1983;40:315-17.
4.
Grossman R., Hamilton R., Morse B., et al. Nontraumatic rhabdomyolysis and acute renal failure. N Engl J Med1974;291(16):807-11.
5.
Koffler A., Friedler R., Massry S.Acute renal failure due to nontraumatic rhabdomyolysis. Ann Intern Med1976;85:23-8.
6.
D'Agostino R. , Arnett E.Acute myoglobinuria and heroin snorting. JAMA1979;241(3):277.
7.
Nanji A., Filipenko J.Rhabdomyolysis and acute myoglobinuric renal failure associated with methadone intoxication. J Toxicol Clin Toxicol1983;20(4):353-60.
8.
Swenson R., Golper T., Bennett W.Acute renal failure and rhabdomyolysis after ingestion of phenylpropanolamine-containing diet pills. JAMA1982;248(10):1216.
