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Suicidal attempt with eliglustat overdose.

Johannes Nadler¹, Maren Hermanns-Clausen¹, Karin Dilger¹

¹Department of General Pediatrics, Adolescent Medicine and Neonatology, Center for Pediatrics Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg Freiburg Germany.

|January 13, 2023

Summary

This summary is machine-generated.

This case report details the successful management of a massive eliglustat overdose in a Gaucher disease type 1 patient. The treatment involved atropine and cafedrine/theoadrenaline, stabilizing the patient after severe bradycardia and hypotension.

Keywords:

Gaucher disease eliglustat overdose poisoning safety suicide attempt

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Area of Science:

Pharmacology
Toxicology
Gastroenterology

Background:

Eliglustat is an orphan drug for Gaucher disease type 1 (GD1), a genetic disorder causing glucosylceramide accumulation.
GD1 symptoms include anemia, fatigue, bruising, enlarged liver/spleen, bone pain, and fractures.
Eliglustat functions as a glucosylceramide synthase inhibitor, a form of substrate reduction therapy.

Observation:

A 29-year-old female with GD1, a poor CYP2D6 metabolizer, ingested approximately 8g of eliglustat in a suicide attempt.
One hour post-ingestion, she presented with somnolence, severe bradycardia (37 bpm), and hypotension (70 mmHg systolic).

Findings:

Intravenous atropine and cafedrine/theoadrenaline administration led to gradual patient recovery.
The patient remained hemodynamically stable for 24 hours in intensive care, with ECG showing supraventricular ectopy and a first-degree AV block.

Implications:

This is the first reported case of a suicidal attempt with eliglustat overdose.
Successful management highlights potential treatment strategies for eliglustat toxicity.
Further research into eliglustat overdose management is warranted given its use in a vulnerable patient population.