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Piroxicam poisoning in a 2-year-old child. A case report
Insights
Accidental piroxicam overdose in a child caused severe gastrointestinal, liver, and kidney issues. The child also experienced bone marrow aplasia and a dangerous Pseudomonas infection.
Area of Science:
- Pharmacology
- Toxicology
- Pediatric Medicine
Background:
- Piroxicam is a widely used non-steroidal anti-inflammatory drug (NSAID).
- Accidental pediatric overdose of NSAIDs can lead to severe adverse events.
- Understanding piroxicam's toxicity profile in children is crucial for safety.
Observation:
- A 2-year-old child ingested 500 mg of piroxicam (5 capsules).
- Symptoms appeared within 2 hours, including severe gastrointestinal distress and fluid/electrolyte imbalance.
- Neurological symptoms (confusion, seizure) and signs of liver/renal dysfunction emerged within 3 days.
Findings:
- The child developed profound hemopoietic toxicity, including pancytopenia and bone marrow aplasia.
- Pseudomonas septicemia occurred during the neutropenic phase.
- Biochemical and hematological abnormalities showed slow resolution over 3-4 weeks.
Implications:
- This case highlights the severe multisystem toxicity associated with piroxicam overdose in children.
- It underscores the importance of strict medication adherence and safe storage of NSAIDs.
- Clinicians should be aware of the potential for serious adverse effects even with a single overdose.
Abstract:
This report describes the severe multisystem toxicity which followed ingestion of 5 piroxicam capsules (100 mg) by a 2-year-old child. Gastro-intestinal symptoms developed within 2 hours, resulting in severe fluid and electrolyte imbalance, mental confusion and a generalized seizure. Evidence of liver and renal dysfunction developed within 3 days. Haemopoietic toxicity was manifested by progressive peripheral pancytopenia, bone marrow aplasia and coagulopathy. Pseudomonas septicaemia developed during the period of neutropenia. Clinical, biochemical and haematological abnormalities slowly resolved over 3-4 weeks. In view of the increasing use of piroxicam as an anti-inflammatory agent it seemed important to draw attention to the potentially serious effects of accidental overdosage.