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Related Experiment Videos

Rhabdomyolysis complicating doxylamine overdose.

F S Mendoza1, J O Atiba, A M Krensky

  • 1Stanford School of Medicine, Children's Hospital at Stanford, Palo Alto, CA 94304.

Clinical Pediatrics
|November 1, 1987
PubMed
Summary

A teen experienced anticholinergic symptoms and kidney issues after an overdose of doxylamine, an antihistamine. This case suggests antihistamine overdose can cause nontraumatic rhabdomyolysis, a serious muscle breakdown condition.

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Area of Science:

  • Toxicology
  • Nephrology
  • Pharmacology

Background:

  • Anticholinergic toxicity can manifest with diverse symptoms.
  • Rhabdomyolysis is a condition involving severe muscle damage.

Observation:

  • A 16-year-old male presented with anticholinergic symptoms, hematuria, and oliguria.
  • Laboratory findings included elevated creatinine, myoglobinuria, and extremely high creatine phosphokinase (CPK) levels.
  • Toxicology screening revealed a massive doxylamine overdose (75 times therapeutic level).

Findings:

  • The patient had no history of trauma or seizures, ruling out common causes of rhabdomyolysis.
  • The severe rhabdomyolysis, indicated by the high CPK level, was strongly associated with the doxylamine overdose.
  • This is the first reported case linking antihistamine overdose to nontraumatic rhabdomyolysis.

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Implications:

  • Doxylamine overdose should be considered a potential cause of nontraumatic rhabdomyolysis.
  • This finding expands the known adverse effects of antihistamines.
  • Highlights the importance of comprehensive toxicological evaluation in patients with unexplained rhabdomyolysis.