title: Hemoperfusion in a child with amitriptyline intoxication.
abstract: Tricyclic antidepressant overdose is one of the most common causes of serious drug poisoning in children and adults. We report a 17-month-old girl with severe amitriptyline intoxication. She was admitted to hospital because of lethargy and seizures. It was estimated that she took approximately 75 mg/kg of amitriptyline 2 h before admission. On examination she was comatose, had ventricular tachycardia and multifocal clonic seizures. Intravenous fluid, per oral activated charcoal, diazepam, lidocaine, and sodium bicarbonate infusion were given. However, there was no response to this therapy, and the patient remained in a deep coma with cardiac arrhythmias and seizures. Hemoperfusion (HP) was performed for 2 h. During this procedure, cardioversion was used six times due to ventricular fibrillation. She had a very good clinical response to HP and no complication was observed. We suggest that HP may be an effective treatment in children with severe amitriptyline intoxication.
authors.affiliation: Department of Pediatric Nephrology, Faculty of Medicine, Uludag University, Bursa, Turkey. odonmez@uludag.edu.tr
authors.forename: Osman
authors.initials: O
authors.lastname: Dönmez
authors.forename: Merih
authors.initials: M
authors.lastname: Cetinkaya
authors.forename: Rahmiye
authors.initials: R
authors.lastname: Canbek
mesh_terms: D000639:Amitriptyline / Q000506:poisoning*; D000929:Antidepressive Agents, Tricyclic / Q000506:poisoning*; D003128:Coma / Q000139:chemically induced / Q000628:therapy*; D004554:Electric Countershock; D005260:Female; D006464:Hemoperfusion; D006801:Humans; D007223:Infant; D012640:Seizures / Q000139:chemically induced / Q000628:therapy; D016896:Treatment Outcome; D014693:Ventricular Fibrillation / Q000139:chemically induced / Q000628:therapy
chemical_list: D000929:Antidepressive Agents, Tricyclic; D000639:Amitriptyline