Rhabdomyolysis after Suicidal Ingestion of an Overdose of Caffeine, Acetaminophen and Phenazone as a Fixed-Dose Combination (Spalt N)

Michaelis, Hans Christoph; Sharifi, Sheida; Schoel, G.

doi:10.3109/15563659109025750

Cited by 12 publications

(8 citation statements)

References 6 publications

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“…The lowest dose of caffeine ingestion in these cases was 20 mg/kg body weight. 17 The longest duration of rising plasma CK levels was 6 days, indicating that the effects of caffeine may persist for a few days. 15 Acute kidney injury occurred in four of six patients and was correlated with extremely high plasma CK levels.…”

Section: Discussionmentioning

confidence: 98%

Rhabdomyolysis induced by excessive coffee drinking

et al. 2013

Hum Exp Toxicol

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Excessive ingestion of caffeine-containing beverages is a rare cause of rhabdomyolysis. Here, we describe the case of a 44-year-old woman presented with nausea, vomiting, palpitations, and tea-colored urine 6 h after drinking a liter of black coffee containing approximately 565 mg of caffeine for mental alertness. Laboratory studies were notable for myoglobinuria and markedly elevated plasma creatine kinase (CK) level of 7315 U/L. With volume expansion and alkalization, her plasma CK level returned to normal within 5 days. Rhabdomyolysis should be considered a potential health hazard from excessive consumption of caffeine-containing products.

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Section: Discussionmentioning

confidence: 98%

Rhabdomyolysis induced by excessive coffee drinking

et al. 2013

Hum Exp Toxicol

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“…Rhabdomyolysis, defined as disintegration or dissolution of muscle associated with excretion of myoglobin in the urine, possibly followed by massive intratubular protein precipitation and renal failure has been only rarely described, and only in one case, was acetaminophen established as the single most likely cause (Michaelis et al. ) (Table ).…”

Section: Discussionmentioning

confidence: 99%

Possible Fatal Acetaminophen Intoxication with Atypical Clinical Presentation

De-Giorgio

Lodise

Chiarotti

et al. 2013

Journal of Forensic Sciences

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Acetaminophen or paracetamol, a commonly used over-the-counter analgesic, is known to elicit severe adverse reactions when taken in overdose, chronically at therapeutic dosage or, sporadically, following single assumptions of a therapeutic dose. Damage patterns including liver damage and, rarely, acute tubular necrosis or a fixed drug exanthema. We present a case of fatal acetaminophen toxicity with postmortem blood concentration 78 μg/mL and unusual clinical features, including a visually striking and massive epidermolysis and rhabdomyolysis, disseminated intravascular coagulation and myocardial ischemia. This case is compared with the most similar previous reports in terms of organ damage, clinical presentation, and cause of death. We conclude that a number of severe patterns of adverse effects to acetaminophen are emerging that were previously greatly underestimated, thus questioning the adequacy of the clinical spectrum traditionally associated with acetaminophen intoxication and leading to the need to review this spectrum and the associated diagnostic criteria.

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“…15,16 Yohimbine is associated with hypertensive crisis when combined with sympathomimetic agents such synephrine, and there is one report of renal failure attributable to the combination. 17,18 We hypothesize that the synephrine and caffeine in this patient's dietary supplement increased this patient's risk of rhabdomyolysis via ischemic injury to muscle through vasoconstriction or vasospasm, myocyte thermoregulatory dysfunction, toxin-associated myocyte injury, or impaired calcium homeostasis causing myonecrosis.…”

Section: Discussionmentioning

confidence: 99%

A Case of Severe Exercise-Induced Rhabdomyolysis Associated with a Weight-Loss Dietary Supplement

Burke¹,

Seda

Allen

et al. 2007

Military Medicine

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In response to questions about the safety of ephedra-based dietary products, ephedra-free products are now available. Many contain synephrine, a sympathomimetic amine with structural similarities to ephedra. We present a 22-year-old, previously healthy, African American male with sickle cell trait who developed rhabdomyolysis after ingestion of a synephrine-containing dietary supplement. The patient developed fatigue, dehydration, and myalgias while exercising. He developed severe rhabdomyolysis, with a peak creatine phosphokinase level of 2.8 million U/L, complicated by pulmonary edema, acute renal failure, disseminated intravascular coagulation, and bilateral compartment syndromes in his lower extremities. He required prolonged hospitalization for hemodialysis, multiple wound debridements, hyperbaric oxygen therapy, and physical therapy. He has permanent sensory and motor neurological deficits in his distal lower extremities. Military physicians should routinely inquire about the use of dietary supplements, educate patients about the potential adverse reactions associated with these agents, and encourage healthy diets and exercise for weight loss.

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Rhabdomyolysis after Suicidal Ingestion of an Overdose of Caffeine, Acetaminophen and Phenazone as a Fixed-Dose Combination (Spalt N)

Cited by 12 publications

References 6 publications

Rhabdomyolysis induced by excessive coffee drinking

Rhabdomyolysis induced by excessive coffee drinking

Possible Fatal Acetaminophen Intoxication with Atypical Clinical Presentation

A Case of Severe Exercise-Induced Rhabdomyolysis Associated with a Weight-Loss Dietary Supplement

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