title: Nonketotic hyperglycemic coma in toddlers after unintentional methadone ingestion.
abstract: Methadone overdoses are increasing in parallel with the increased frequency of opiate substitution therapy in adults. Although unintentional methadone intoxication in children is rare, it is becoming more frequently recognized. We report 3 cases of unintentional methadone overdose in toddlers who initially displayed central nervous system depression associated with severe nonketotic hyperglycemia and discuss the possible pathophysiologic mechanisms of an underrecognized symptom of opiate intoxication in young children.
authors.affiliation: Intensive Care Unit, Department of Pediatrics, Bicetre Hospital, Le Kremlin-Bicêtre, France.
authors.forename: Sinan
authors.initials: S
authors.lastname: Tiras
authors.forename: Vincent
authors.initials: V
authors.lastname: Haas
authors.forename: Laurent
authors.initials: L
authors.lastname: Chevret
authors.forename: Marion
authors.initials: M
authors.lastname: Decobert
authors.forename: Anne
authors.initials: A
authors.lastname: Buisine
authors.forename: Denis
authors.initials: D
authors.lastname: Devictor
authors.forename: Philippe
authors.initials: P
authors.lastname: Durand
authors.forename: Pierre
authors.initials: P
authors.lastname: Tissières
mesh_terms: D000061:Accidents, Home; D000818:Animals; D001925:Brain Damage, Chronic / Q000209:etiology; D002675:Child, Preschool; D003922:Diabetes Mellitus, Type 1 / Q000175:diagnosis; D003951:Diagnostic Errors; D004280:Dobutamine / Q000627:therapeutic use; D004349:Drug Packaging; D004837:Epinephrine / Q000627:therapeutic use; D005260:Female; D005602:France; D006801:Humans; D006944:Hyperglycemic Hyperosmolar Nonketotic Coma / Q000139:chemically induced* / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy; D007223:Infant; D007328:Insulin / Q000627:therapeutic use; D007515:Islets of Langerhans / Q000187:drug effects / Q000503:physiopathology; D008297:Male; D008691:Methadone / Q000494:pharmacology / Q000506:poisoning*; D051379:Mice; D009102:Multiple Organ Failure / Q000209:etiology; D009203:Myocardial Infarction / Q000209:etiology; D009270:Naloxone / Q000627:therapeutic use; D011972:Receptor, Insulin / Q000187:drug effects; D017450:Receptors, Opioid, mu / Q000187:drug effects / Q000502:physiology; D012770:Shock, Cardiogenic / Q000209:etiology; D013549:Sweetening Agents; D013997:Time Factors
chemical_list: D007328:Insulin; D017450:Receptors, Opioid, mu; D013549:Sweetening Agents; D009270:Naloxone; D004280:Dobutamine; D011972:Receptor, Insulin; D008691:Methadone; D004837:Epinephrine