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Related Experiment Videos

Fatal overdosage with cisplatin.

C Charlier1, P Kintz, N Dubois

  • 1Laboratory of Clinical Toxicology, University Hospital, Liege, Belgium. C.CHARLIER@chu.ulg.ac.be

Journal of Analytical Toxicology
|April 8, 2004
PubMed
Summary
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A fatal cisplatin overdosage occurred in a lymphoma patient due to accidental massive administration. Postmortem platinum levels were high, and despite dialysis, the patient developed severe organ damage and died.

Area of Science:

  • Oncology
  • Clinical Toxicology
  • Pharmacokinetics

Background:

  • Cisplatin is a platinum-based chemotherapy agent widely used for various cancers, including lymphoma.
  • Accidental medication errors in dosage administration can lead to severe toxicity.
  • Understanding platinum pharmacokinetics is crucial for managing cisplatin therapy and overdose.

Observation:

  • A 63-year-old lymphoma patient received a massive accidental overdose of cisplatin (750 mg instead of 170 mg).
  • Inductively coupled plasma mass spectrometry detected high postmortem platinum concentrations in blood (1515 µg/L in heart, 1253 µg/L in peripheral), urine (1038 µg/L), and bile (501 µg/L).

Findings:

  • Despite immediate initiation of renal dialysis upon recognizing the overdose, the patient succumbed 16 days later.

Related Experiment Videos

  • The patient exhibited severe renal and hepatic insufficiency, ototoxicity, and pancytopenia, consistent with cisplatin toxicity.

    • Implications:

    • This case highlights the critical importance of meticulous medication administration protocols in chemotherapy.
    • It underscores the severe toxicities associated with cisplatin overdose and the limitations of interventions like dialysis in such extreme scenarios.
    • Further research into enhanced monitoring and management strategies for cisplatin extravasation and overdose is warranted.