Modern Intermittent Haemodialysis (IHD) is an Effective Method of Removing Salicylate in Chronic Topical Salicylate Toxicity.
BACKGROUND
There are limited data on modern intermittent hemodialysis (IHD) efficacy on salicylate elimination from topical poisoning.


METHODS
A 54-year-old male sought treatment for dyspnea but was then diagnosed with salicylate toxicity from topical application of Dencorub Extra Strength Heat Gel® for 1 week. Each tube contained 100 g with 26 % methylsalicylate (26 g). Laboratory workup was remarkable for an elevated anion gap of 30 and salicylate concentration of 78.7 mg/dL [5.7 mmol/L (N < 0.4 mmol/L)]. Treatment with urinary alkalinization was followed by hemodialysis for 5 h. Extraction ratios were 0.44 with clearance rates of 78.5 mL/min. Salicylate concentrations fell rapidly following initiation of hemodialysis with no rebound observed.


CONCLUSIONS
Modern high flux IHD is an effective method of removing salicylates in the treatment of chronic topical poisoning.
Victorian Poisons Information Centre and Austin Toxicology Service, Austin Hospital, Melbourne, Victoria, Australia. anselm.wong@austin.org.au.|School of Clinical Sciences, Department of Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Victoria, Australia. anselm.wong@austin.org.au.
Anselm
A
Wong
Renal unit, Liverpool Hospital, Sydney, NSW, Australia.
Kathy
K
Mac
Intensive Care Unit, Liverpool Hospital, Sydney, NSW, Australia.
Anders
A
Aneman
Renal unit, Liverpool Hospital, Sydney, NSW, Australia.
Jeffrey
J
Wong
Clinical Toxicology Unit, Prince of Wales Hospital, Sydney, NSW, Australia.
Betty S
BS
Chan
D000279:Administration, Cutaneous; D018501:Antirheumatic Agents / Q000008:administration & dosage / Q000097:blood / Q000493:pharmacokinetics / Q000506:poisoning*; D062787:Drug Overdose / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis / Q000379:methods*; D012120:Respiration Disorders / Q000139:chemically induced / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D012459:Salicylates / Q000008:administration & dosage / Q000097:blood / Q000493:pharmacokinetics / Q000506:poisoning*; D016896:Treatment Outcome
D018501:Antirheumatic Agents; D012459:Salicylates; C033069:methyl salicylate
Hemodialysis; Poisoning; Salicylate; Topical