Pronounced metabolic response to modest theophylline overdose.
OBJECTIVE
To describe a patient who developed significant metabolic abnormalities in response to a low-level theophylline ingestion.


METHODS
An 18-year-old man was examined after ingesting theophylline 3 g in a suicide attempt. Although his peak theophylline concentration was 157 mumol/L (28.2 micrograms/mL), it was associated with significant leukocytosis, hypokalemia, hypomagnesemia, hypophosphatemia, hyperglycemia, and lactic acidosis. These abnormalities have been previously associated with theophylline intoxication, but only in conjunction with much higher peak concentrations of theophylline.


CONCLUSIONS
Significant metabolic abnormalities can occur with suicidal ingestion of relatively small amounts of theophylline. The presence of these abnormalities should be sought in theophylline overdoses. In the proper clinical circumstances, such abnormalities should raise suspicion of covert theophylline ingestion.
Hagley
M T
MT
Department of Internal Medicine, Akron City Hospital, OH.
Traeger
S M
SM
Schuckman
H
H
D000140:Acidosis, Lactic / Q000139:chemically induced; D000293:Adolescent; D062787:Drug Overdose; D006801:Humans; D006943:Hyperglycemia / Q000139:chemically induced; D007008:Hypokalemia / Q000139:chemically induced; D017674:Hypophosphatemia / Q000139:chemically induced; D007964:Leukocytosis / Q000139:chemically induced*; D008274:Magnesium / Q000097:blood; D008297:Male; D008659:Metabolic Diseases / Q000097:blood / Q000139:chemically induced*; D013406:Suicide, Attempted; D013806:Theophylline / Q000097:blood / Q000506:poisoning*
D013806:Theophylline; D008274:Magnesium