Nonketotic hyperglycemic coma in toddlers after unintentional methadone ingestion.
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.
Tiras
Sinan
S
Intensive Care Unit, Department of Pediatrics, Bicetre Hospital, Le Kremlin-Bicêtre, France.
Haas
Vincent
V
Chevret
Laurent
L
Decobert
Marion
M
Buisine
Anne
A
Devictor
Denis
D
Durand
Philippe
P
Tissières
Pierre
P
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
D007328:Insulin; D017450:Receptors, Opioid, mu; D013549:Sweetening Agents; D009270:Naloxone; D004280:Dobutamine; D011972:Receptor, Insulin; D008691:Methadone; D004837:Epinephrine