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[Neonatal intoxication with pyrimethamine: risk due to the absence of pediatric formulation?]

M Genuini1, C Freihuber, I Girard

  • 1Service de néonatologie, hôpital Armand-Trousseau, faculté de médecine, AP-HP, université Pierre-et-Marie-Curie, 26, avenue du Dr-Arnold-Netter, 75571 Paris cedex 12, France.

Archives De Pediatrie : Organe Officiel De La Societe Francaise De Pediatrie
|September 3, 2011
PubMed

Insights

A newborn experienced seizures and cholestasis after a 100x pyrimethamine overdose for congenital toxoplasmosis. This case highlights the need for pediatric formulations and careful dosing of pyrimethamine in infants.

Area of Science:

  • Pediatric Pharmacology
  • Infectious Diseases
  • Clinical Toxicology

Background:

  • Congenital toxoplasmosis treatment relies on pyrimethamine and sulfonamides.
  • Existing treatments lack pediatric-specific formulations, posing dosing challenges.
  • Accurate dosing is critical, especially in neonates.

Observation:

  • A newborn with asymptomatic congenital toxoplasmosis received a pyrimethamine dose 100 times the recommended amount.
  • The infant developed partial seizures 48 hours post-overdose.
  • Symptoms included appetite loss and vomiting, with spontaneous resolution within 5 days.

Findings:

  • The overdose resulted in moderate, self-resolving cholestasis.
  • Seizures were a key adverse event linked to the pyrimethamine toxicity.
  • Clinical presentation and laboratory findings indicate a need for vigilant monitoring.

Implications:

  • This case underscores the critical need for pediatric-friendly pyrimethamine formulations.
  • It emphasizes the importance of precise prescription and administration protocols for neonates.
  • Further research into safe dosing ranges and management of pyrimethamine toxicity in infants is warranted.

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