Charcoal hemoperfusion treatment of severe theophylline toxicity

A 38 year old man was admitted eight hours after taking ten grams of theophylline. The plasma concentration of theophylline on admission was 732 mumol/l. In view of the patient's continuing clinical deterioration, charcoal hemoperfusion was undertaken. This led to a rapid fall in plasma theophylline concentrations and improvement in clinical signs. It is suggested that charcoal hemoperfusion has a role in the severely theophylline toxic patient in whom standard conservative measures are failing. The patient's hyperglycemia, metabolic acidosis, and hypokalemia are discussed.