title: [Fatal suicidal intoxication with cetirizine in patient with anorexia--a case report].
abstract: According to the best of our knowledge this is the first case of acute fatal intoxication with cetirizine published in medical literature. We have described the case of a 18-year-old female with the history of anorexia for 2 years, who was admitted to Clinic of Toxicology because of suicidal attempt with use of cetirizine. The laboratory results revealed metabolic acidosis with the pH 7.13; pO2 88 mm Hg; pCO2 36 mm Hg; HCO3 12.0 mmol/L; BE (-)17 mmol/L; SO2 100% and hypokalemia (K+ 3.1 mmol/L). On physical examination blood pressure was 70/40 mm Hg, heart rate was 36-40 beats/min. Convulsions were observed. After about two hours of intensive treatment there was a cardiac arrest in the form of ventricular fibrillation. The resuscitation procedures which lasted for over 2.5 hours were ineffective. The high dose (270 mg) of cetirizine as well as anorexia and hypokalemia could have been the cause of the unique character of the symptoms in this case. Further investigations should be carried out to confirm the safety of cetirizine in the conditions of massive intoxication and with coexistence of other risk factors.
authors.affiliation: I Klinika Chorób Wewnetrznych i Ostrych Zatruć, Akademii Medycznej w Gdańsku. jsanand@amedec.amg.gda.pl
authors.forename: Zygmunt
authors.initials: Z
authors.lastname: Chodorowski
authors.forename: Jacek
authors.initials: J
authors.lastname: Sein Anand
authors.forename: Hanna
authors.initials: H
authors.lastname: Kujawska
mesh_terms: D000138:Acidosis / Q000209:etiology; D000293:Adolescent; D000855:Anorexia / Q000150:complications*; D018926:Anti-Allergic Agents / Q000506:poisoning*; D001919:Bradycardia / Q000209:etiology; D017332:Cetirizine / Q000506:poisoning*; D017809:Fatal Outcome; D005260:Female; D006323:Heart Arrest / Q000209:etiology; D006801:Humans; D007008:Hypokalemia / Q000150:complications / Q000209:etiology; D007022:Hypotension / Q000209:etiology; D012640:Seizures / Q000209:etiology; D013405:Suicide
chemical_list: D018926:Anti-Allergic Agents; D017332:Cetirizine