2011
DOI: 10.1136/bcr.11.2011.5093
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Running a risk? Sport supplement toxicity with ephedrine in an amateur marathon runner, with subsequent rhabdomyolysis

Abstract: A 36-year-old man presented to the emergency department acutely unwell after being found collapsed while running a halfmarathon. He presented with a reduced Glasgow coma score, was tachycardic, agitated, hypoxic and profusely sweating. He had taken a 'supplement' given to him prior to the race by a friend, as he was concerned about not finishing. This contained both caffeine and a large dose of ephedrine (60 mg in total). After initial resuscitation he was intubated, and was transferred to critical care. He su… Show more

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Cited by 11 publications
(3 citation statements)
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“…Various modalities were used for myoglobin clearance, with the most common being plasmapheresis/therapeutic plasma exchange (nine studies), coupled plasma filtration-absorption (1 study, n=4; Pezzi et al), high flux dialyzer (1 study, n=6; Sorrenti), super high flux membrane (n=1; Naka), and the Cytosorb system, which is a hemoadsorption cartridge added to the hemodialysis circuit (three studies, n=3) [7][8][9][10][11][12][13][14][15][16][17]. On the other hand, several case reports and case series published during this time did not use any modality for myoglobin clearance and used supportive care and other treatments [18][19][20][21][22][23][24][25][26][27][28].…”
Section: Discussionmentioning
confidence: 99%
“…Various modalities were used for myoglobin clearance, with the most common being plasmapheresis/therapeutic plasma exchange (nine studies), coupled plasma filtration-absorption (1 study, n=4; Pezzi et al), high flux dialyzer (1 study, n=6; Sorrenti), super high flux membrane (n=1; Naka), and the Cytosorb system, which is a hemoadsorption cartridge added to the hemodialysis circuit (three studies, n=3) [7][8][9][10][11][12][13][14][15][16][17]. On the other hand, several case reports and case series published during this time did not use any modality for myoglobin clearance and used supportive care and other treatments [18][19][20][21][22][23][24][25][26][27][28].…”
Section: Discussionmentioning
confidence: 99%
“…Although cases of lethal intoxication have been mainly associated with the occurrence of arrhythmic events induced by caffeine, human studies provided scarce evidence to support the substance’s ability to induce arrhythmic events in healthy subjects and in subjects predisposed to such events [ 2 , 46 , 47 , 48 , 49 ]. These findings, however, even if provided by studies differing in sample size and methods, should not be considered in disagreement with the conclusions of those studies reporting cases of lethal intoxication, as they take into account caffeine doses below the ones considered toxic for humans.…”
Section: Discussionmentioning
confidence: 99%
“…After initial resuscitation, he was intubated, and transferred to critical care. He subsequently developed rhabdomyolysis, requiring hemofiltration before being discharged from critical care and having further intermittent renal replacement therapy [ 133 ], thereafter.…”
Section: Ephedrinementioning
confidence: 99%