Recrudescent Digoxin Toxicity Treated with Plasma Exchange: A Case Report and Review of Literature

被引:0
|
作者
Saurabh Rajpal
Jagan Beedupalli
Pratap Reddy
机构
[1] Louisiana State University Health Sciences Center,Department of Medicine
[2] Louisiana State University Health Sciences Center,Division of Cardiology
来源
Cardiovascular Toxicology | 2012年 / 12卷
关键词
Recrudescent digoxin toxicity; Plasma exchange; Digoxin antibody; Arrythmias;
D O I
暂无
中图分类号
学科分类号
摘要
A 53-year-old woman presented with digitalis toxicity caused by acute overdose that manifested as atrial tachycardia with block, sinus pauses, and competing AV junctional rhythm with atrial fibrillation. Patient admitted to overdosing with digoxin 15–20 h before presentation with intent to commit suicide. Serum digoxin level was 35.6 ng/ml and renal function was normal. Patient was treated with 1,040 mg of digoxin-specific antibody Fab fragment with prompt resolution of arrhythmias and restoration of sinus rhythm. Four hours after digoxin antibody administration, serum digoxin level declined to 0.2 ng/ml. Eighteen hours after treatment with Fab fragment, patient developed premature ventricular complexes, atrial tachycardia with and without atrioventricular block, and non-sustained ventricular tachycardia followed by ventricular fibrillation from which she was successfully resuscitated. Electrocardiogram showed no evidence of acute myocardial infarction, and emergent coronary angiogram did not reveal significant coronary artery disease. Repeat digoxin level was 20.4 ng/ml. A diagnosis of recrudescent digoxin toxicity was made and the patient was treated with one session of plasma exchange with resolution of arrhythmias. Immediately after plasma exchange, digoxin level decreased to 10.4 ng/ml, and after 10 h, the level further decreased to 6.6 ng/ml. The following day, digoxin level had decreased to 2.9 ng/ml. Our experience with this case would suggest that plasma exchange should be considered as a treatment modality for recrudescent digoxin toxicity.
引用
收藏
页码:363 / 368
页数:5
相关论文
共 50 条
  • [1] Recrudescent Digoxin Toxicity Treated with Plasma Exchange: A Case Report and Review of Literature
    Rajpal, Saurabh
    Beedupalli, Jagan
    Reddy, Pratap
    [J]. CARDIOVASCULAR TOXICOLOGY, 2012, 12 (04) : 363 - 368
  • [2] Plasma exchange for the management of digoxin toxicity in an individual with an acute kidney injury: A case report
    Preston, Hannah
    Cannon, Emma
    Watson, Simon
    [J]. JOURNAL OF THE ROYAL COLLEGE OF PHYSICIANS OF EDINBURGH, 2024, 54 (01): : 55 - 58
  • [3] Spectrum of digoxin-induced ocular toxicity: A case report and literature review Case Reports
    Renard D.
    Rubli E.
    Voide N.
    Borruat F.-X.
    Rothuizen L.E.
    [J]. BMC Research Notes, 8 (1)
  • [4] Severe Hyperthyroidism Complicated by Agranulocytosis Treated with Therapeutic Plasma Exchange: Case Report and Review of the Literature
    Garla, Vishnu
    Kovvuru, Karthik
    Ahuja, Shradha
    Palabindala, Venkatataman
    Malhotra, Bharat
    Salim, Sohail Abdul
    [J]. CASE REPORTS IN ENDOCRINOLOGY, 2018, 2018
  • [5] A rare case of acute cerebellitis due to enterovirus treated with therapeutic plasma exchange: Case report and review of the literature
    Akcay, Nihal
    Topal, Neval
    Semerci, Seda Yilmaz
    [J]. JOURNAL OF CLINICAL APHERESIS, 2024, 39 (04)
  • [6] HCV related severe cryoglobulinemic vasculitis treated with plasma exchange and rituximab: case report and literature review
    Arandjelovic, Snezana
    Bonaci-Nikolic, Branka
    Peric-Popadic, Aleksandra
    Tomic-Spiric, Vesna
    Bolpacic, Jasna
    Raskovic, Sanvila
    Andrejevic, Sladjana
    [J]. JOURNAL OF INFECTION IN DEVELOPING COUNTRIES, 2017, 11 (05): : 431 - 436
  • [7] Therapeutic plasma exchange in amitriptyline intoxication: Case report and review of the literature
    Sari, Ismail
    Turkcuer, Ibrahim
    Erurker, Tuba
    Serinken, Mustafa
    Seyit, Murat
    Keskin, Ali
    [J]. TRANSFUSION AND APHERESIS SCIENCE, 2011, 45 (02) : 183 - 185
  • [9] The use of plasma exchange in Hashimoto's encephalopathy: A case report and review of the literature
    Cook, Melissa K.
    Malkin, Mark
    Karafin, Matthew S.
    [J]. JOURNAL OF CLINICAL APHERESIS, 2015, 30 (03) : 188 - 192