title: Severe Carbamazepine Intoxication in Children: Analysis of a 40-Case Series.
abstract: BACKGROUND We compared the factors that might impact the severity and the prognosis of carbamazepine (CBZ) intoxication in children, as well as the efficacy levels of the treatment options. MATERIAL AND METHODS Demographic information and clinical and laboratory findings for 40 patients were evaluated retrospectively. Predictive parameters for the development of serious complications were studied. RESULTS Median age of patients was 14 years; 65% of the patients were female. The most common pathological clinical finding and laboratory abnormality were inability to awaken the patient and hyperglycemia (45% and 60%, respectively). The incidences of convulsion, coma, and respiratory failure were 14 (35%), 10 (25%), and 3 (7.5%), respectively. The Glasgow Coma Scale (GCS) scores and pH levels at emergency service admission were significantly lower in the severe intoxication group and the ICU admission group, and body temperature and serum glucose and lactate levels were significantly higher in these groups. A significantly negative correlation was found between the serum CBZ level and the GCS score, but the serum CBZ level was found to be significantly positively correlated with the lactate level. CONCLUSIONS According to our study, the GCS score at admission to hospital, the serum CBZ, glucose, pH, and lactate levels, and body temperature might be useful in predicting serious CBZ intoxication and prognosis in pediatric cases. We conclude that invasive treatment methods, such as hemodialysis or albumin-enhanced continuous venovenous hemodialysis, should be used in patients who do not respond to supportive treatment.
authors.affiliation: Department of Pediatrics, Ondokuz Mayıs University, Medical Faculty, Samsun, Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Acikgoz
authors.affiliation: Department of Pediatrics, Ondokuz Mayıs University, Medical Faculty, Samsun, Turkey.
authors.forename: M Sukru
authors.initials: MS
authors.lastname: Paksu
authors.affiliation: Department of Pediatrics, Ondokuz Mayıs University, Medical Faculty, Samsun, Turkey.
authors.forename: Ahmet
authors.initials: A
authors.lastname: Guzel
authors.affiliation: Department of Pediatrics, Ondokuz Mayıs University, Medical Faculty, Samsun, Turkey.
authors.forename: Abdurrahman
authors.initials: A
authors.lastname: Alacam
authors.affiliation: Department of Pediatrics, Ondokuz Mayıs University, Medical Faculty, Samsun, Turkey.
authors.forename: Fatma
authors.initials: F
authors.lastname: Alacam
mesh_terms: D000293:Adolescent; D001930:Brain Injuries / Q000097:blood / Q000139:chemically induced; D002220:Carbamazepine / Q000097:blood / Q000506:poisoning*; D002648:Child; D002675:Child, Preschool; D003128:Coma / Q000097:blood / Q000139:chemically induced; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D006943:Hyperglycemia / Q000139:chemically induced; D007223:Infant; D008297:Male; D011379:Prognosis; D012189:Retrospective Studies; D012640:Seizures / Q000097:blood / Q000139:chemically induced
chemical_list: D002220:Carbamazepine