- 著者
- Toshikazu Ozeki Rui Kawato Mitsuru Watanabe Shun Minatoguchi Yukari Murai Akihiro Ryuge Koji Takasugi Takuya Hamada Yukako Oyama Atsushi Nomura Tatsuhito Tomino Hideaki Shimizu Yoshiro Fujita
- 出版者
- 一般社団法人 日本内科学会
- 雑誌
- Internal Medicine (ISSN:09182918)
- 巻号頁・発行日
- vol.55, no.7, pp.775-778, 2016 (Released:2016-04-01)
- 参考文献数
- 15
- 被引用文献数
- 1 8
A 72-year-old woman with a history of type 2 diabetes mellitus was brought to the ER with metformin-associated lactic acidosis. She received continuous hemofiltration and hemodialysis, but the laboratory analyses showed no improvement. She died 11 hours after admission. Metformin is minimally bound to proteins and is readily dialyzable, but a prolonged period of dialysis is required, because metformin has a very large distribution volume and is distributed to multiple compartments. The peak blood metformin level was 432 mg/L in this case, which is one of the highest metformin concentrations ever reported, and eight hours of hemodialysis were not sufficient to reduce the serum level.
1 0 0 0 OA Pilsicainide Intoxication with Neuropsychiatric Symptoms Treated with Continuous Hemodiafiltration
- 著者
- Marina Asano Takuto Hayakawa Yuki Kato Kyogo Kawada Shuji Goto Joel Branch Hideaki Shimizu
- 出版者
- The Japanese Society of Internal Medicine
- 雑誌
- Internal Medicine (ISSN:09182918)
- 巻号頁・発行日
- vol.59, no.17, pp.2191-2195, 2020-09-01 (Released:2020-09-01)
- 参考文献数
- 19
- 被引用文献数
- 3
A 72-year-old lady with atrial fibrillation and chronic renal failure was hospitalized due to bradycardic shock with electrocardiographic QRS prolongation. She had experienced limb shaking two days before hospitalization, and additionally developed hallucinations one day before admission. Pilsicainide intoxication was diagnosed from a review of her medications and electrocardiographic findings. Consequently, continuous hemodiafiltration was performed resulting in a resolution of the hallucinations and the QRS prolongation. This is a rare case of psychiatric symptoms caused by pilsicainide intoxication. It is important to know the mode of excretion of a drug and to adjust its dose, so that such drug-related incidents can be avoided.