Massive Nonfatal Hydroxychloroquine Ingestion in a Pediatric Patient

Priya Srihari, Alicia B. Minns, Han T. Gao, Allyson A. Kreshak

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Hydroxychloroquine overdose is rare but potentially lethal. Hydroxychloroquine overdose symptoms are characterized by central nervous system toxicity, cardiac toxicity, and hypokalemia. Recommended treatment consists of epinephrine, high-dose diazepam, and careful potassium repletion. Few pediatric hydroxychloroquine overdoses have been reported. Case Report: We describe a 14-year-old girl who ingested 10 g (172 mg/kg) of hydroxychloroquine. She developed tachycardia, hypotension, and hypokalemia. She was intubated and treated with diazepam and epinephrine infusions and potassium supplementation. Her serum hydroxychloroquine concentration obtained 10 h after ingestion was 13,000 ng/mL (reference range 500–2000 ng/mL). The patient made a full medical recovery. Why Should an Emergency Physician Be Aware of This?: Pediatric hydroxychloroquine overdoses are reported rarely, and the toxic and lethal doses of hydroxychloroquine ingestion have not been established. This case of a teenaged patient who ingested 10 g of hydroxychloroquine and survived provides additional information that may be used to help establish toxic and lethal doses of ingestion.

Original languageEnglish (US)
Pages (from-to)332-336
Number of pages5
JournalJournal of Emergency Medicine
Volume62
Issue number3
DOIs
StatePublished - Mar 2022

Keywords

  • chloroquine
  • hydroxychloroquine
  • overdose
  • pediatric
  • poisoning

ASJC Scopus subject areas

  • Emergency Medicine

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