title: Acute renal insufficiency in ibuprofen overdose.
abstract: Since the introduction of ibuprofen as a nonprescription drug in the US, there have been reports of significant toxicity associated with large ingestions (> 400 mg/kg) in both children and adults. Acute renal insufficiency is a rare, reversible effect of ibuprofen overdose documented in adults, but we could find no published pediatric cases. We report a case of a healthy two-year-old boy, without a previous history of renal problems, who developed reversible acute renal insufficiency after a toxic ingestion of approximately 640 mg/kg ibuprofen. By 11 hours, his initially normal creatinine began to rise, reaching a peak value of 181 mmol/L (2.1 mg/dl) by 27 hours. His urinalysis showed moderate microscopic hematuria without the presence of casts or proteinuria. No problems arose with fluid management. Normalization of his renal function occurred by 72 hours. A serum ibuprofen concentration obtained by high-performance liquid chromatography and drawn approximately four hours after ingestion was 1724 mumol (therapeutic serum concentration, 50-250 mumol). This case demonstrates that acute, reversible renal insufficiency can occur in healthy children after a severe overdose of ibuprofen; hence, renal function should be monitored in such instances.
authors.affiliation: Division of Gastroenterology, Hospital for Sick Children, University of Toronto, Ontario, Canada.
authors.forename: J
authors.initials: J
authors.lastname: Kim
authors.forename: M
authors.initials: M
authors.lastname: Gazarian
authors.forename: Z
authors.initials: Z
authors.lastname: Verjee
authors.forename: D
authors.initials: D
authors.lastname: Johnson
mesh_terms: D058186:Acute Kidney Injury / Q000139:chemically induced*; D002675:Child, Preschool; D062787:Drug Overdose / Q000628:therapy; D006801:Humans; D007052:Ibuprofen / Q000506:poisoning*; D008297:Male
chemical_list: D007052:Ibuprofen