Cerebral infarcts in a pediatric patient secondary to phenylpropanolamine, a recalled medication.
Phenylpropanolamine (PPA) recently has been publicly implicated as a cause of stroke and other neurologic events. In November of 2000, the Food and Drug Administration (FDA) requested a voluntary recall of the product from all manufacturers. However, medications containing PPA still can be found in many homes of those unaware of the voluntary recall. We present a case of stroke after PPA ingestion that occurred 4 months after the recall in an 8-year-old boy on chronic peritoneal dialysis. The patient developed occipital infarcts and was found to have extremely elevated levels of PPA in his blood and dialysis fluid. Though the voluntary recall was in effect, the family already had a bottle of the medication at home. Physicians must be aware that the public is still ingesting the drug and remain rigorous in including its toxicity in the differential diagnosis of acute neurologic events.
Delorio
Nicole M
NM
Department of Emergency Medicine, Oregon Health and Science University, Portland, Oregon 97201, USA.
D002544:Cerebral Infarction / Q000139:chemically induced* / Q000150:complications / Q000175:diagnosis / Q000628:therapy; D002648:Child; D004335:Drug and Narcotic Control; D006261:Headache / Q000209:etiology; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000628:therapy; D007668:Kidney / Q000002:abnormalities; D008297:Male; D014663:Nasal Decongestants / Q000009:adverse effects*; D004366:Nonprescription Drugs / Q000009:adverse effects*; D010530:Peritoneal Dialysis; D010665:Phenylpropanolamine / Q000009:adverse effects*; D012141:Respiratory Tract Infections / Q000150:complications / Q000188:drug therapy*; D012640:Seizures / Q000209:etiology; D016896:Treatment Outcome; D014657:Vasculitis / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D014786:Vision Disorders / Q000209:etiology
D014663:Nasal Decongestants; D004366:Nonprescription Drugs; D010665:Phenylpropanolamine