[Anti-digoxin antibodies in severe digitalis poisoning in an 11-day old infant. Review of the literature].
Acute digitalis intoxication bringing into play the prognosis for survival is a rare complication in children, particularly in the neonatal period. We describe the case of an accidental massive digitalis intoxication in a newborn aged 11 days, which caused a complete atrioventricular block and a state of cardiogenic shock. The outcome was favorable four hours after administration of the first dose of anti-digoxin antibodies, with a complete reversal of clinical and electrocardiographic signs. The onset of first-degree atrioventicular block 48 hours afterward made us consider the possibility of the tissular salting-out effect of the digoxin and led us to administer a second dose of specific antibodies. The originality of this case has to do with the severity of the initial clinical picture, its total reversal with antibodies and the salting-out phenomena that followed. The case reminds us, along with the data in the literature, the criteria of wrong prognoses in massive digitalis intoxication in the child and the indications for anti-digoxin antibodies.
Laurent
G
G
Unité de cardiologie pédiatrique, centre de cardiologie, hôpital d'enfants, centre de cardiologie, hôpital du Bocage, 2, boulevard Maréchal de Lattre de Tassigny, 21034 Dijon, France. gaby.nathalie@free.fr
Poulet
B
B
Falcon-Eicher
S
S
Petit
A
A
Ballout
J
J
Iovescu
D
D
Gouyon
J B
JB
Louis
P
P
D000906:Antibodies / Q000627:therapeutic use*; D004070:Digitalis / Q000506:poisoning*; D004077:Digoxin / Q000276:immunology*; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D012720:Severity of Illness Index
D000906:Antibodies; D004077:Digoxin