Gitaloxin poisoning in a child.
Gitaloxin is a digitalis glycoside used for the same indications as digoxin and digitoxin. The successful outcome for a 2 1/2-year-old boy who accidentally ingested 3 mg of gitaloxin (100 times the normal therapeutic dose) is reported. At admission the child presented with irregular heart rhythm. He subsequently started vomiting, even after continuous gastric feeding. Only 48 h after ingestion of gitaloxin he became somnolent and developed bradyarrhythmia. The symptoms disappeared 96 h later; the bradyarrhythmia, however, (second-degree atrioventricular block) decreased progressively only after 120 h. The initial clinical presentation of gitaloxin poisoning may be misleading and careful observation in a pediatric intensive care unit is mandatory. A cross-reaction between the fluorescence polarization immunoassay for digitoxin and the radioimmunoassay for gitaloxin was found and was used as a helpful, but rough, estimate of the severity of gitaloxin poisoning, in the absence of a specific measurement of gitaloxin.
Hachimi-Idrissi
S
S
Toxicology Department, University Hospital, Free University Brussels, Belgium.
Corne
L
L
Maes
V
V
Ramet
J
J
D001919:Bradycardia / Q000139:chemically induced; D002675:Child, Preschool; D003422:Critical Care; D004077:Digoxin / Q000031:analogs & derivatives* / Q000506:poisoning; D004562:Electrocardiography; D016231:Fluorescence Polarization Immunoassay; D006801:Humans; D008297:Male; D011041:Poisoning / Q000097:blood / Q000175:diagnosis / Q000628:therapy; D014839:Vomiting / Q000139:chemically induced
D004077:Digoxin; C021029:gitaloxin