title: Felbamate overdose complicated by massive crystalluria and acute renal failure.
abstract: We report a 20-year-old woman who developed altered mental status, massive crystalluria, and acute renal failure following an intentional overdose of felbamate and sodium valproate. Peak plasma concentrations of felbamate and sodium valproate were 200 microg/mL and 470 microg/mL, respectively. Macroscopic urinary crystals formed approximately 18 hours after ingestion and were identified by gas chromatography as containing felbamate. Renal ultrasound revealed unilateral hydronephrosis. Following parenteral hydration, the crystalluria and acute renal failure resolved and the patient recovered. The frequency and significance of crystalluria in felbamate intoxication is unknown.
authors.affiliation: Vanderbilt University Medical Center, Nashville, Tennessee 37232-2656, USA.
authors.forename: D S
authors.initials: DS
authors.lastname: Rengstorff
authors.forename: A P
authors.initials: AP
authors.lastname: Milstone
authors.forename: D L
authors.initials: DL
authors.lastname: Seger
authors.forename: T J
authors.initials: TJ
authors.lastname: Meredith
mesh_terms: D058186:Acute Kidney Injury / Q000097:blood / Q000209:etiology* / Q000652:urine; D000328:Adult; D000927:Anticonvulsants / Q000097:blood / Q000506:poisoning* / Q000652:urine; D002849:Chromatography, Gas; D003460:Crystallization; D004347:Drug Interactions; D062787:Drug Overdose; D000078328:Felbamate; D005260:Female; D006801:Humans; D006869:Hydronephrosis / Q000139:chemically induced / Q000000981:diagnostic imaging; D048448:Phenylcarbamates; D011041:Poisoning / Q000097:blood / Q000150:complications* / Q000652:urine; D011409:Propylene Glycols / Q000097:blood / Q000506:poisoning* / Q000652:urine; D013406:Suicide, Attempted; D014463:Ultrasonography; D014635:Valproic Acid / Q000097:blood / Q000506:poisoning
chemical_list: D000927:Anticonvulsants; D048448:Phenylcarbamates; D011409:Propylene Glycols; D014635:Valproic Acid; D000078328:Felbamate