Not only Van Gogh: a case of BRASH syndrome with concomitant digoxin toxicity.
Humans
Female
Aged
Digoxin
/ adverse effects
Hyperkalemia
/ chemically induced
Bradycardia
/ chemically induced
Renal Dialysis
Renal Insufficiency
/ chemically induced
Anti-Arrhythmia Agents
/ adverse effects
Syndrome
Acidosis
/ chemically induced
Shock
/ chemically induced
Atrioventricular Block
/ chemically induced
Immunoglobulin Fab Fragments
BRASH syndrome
Bradycardia
Case report
Digoxin toxicity
Hyperkalemia
Journal
Journal of medical case reports
ISSN: 1752-1947
Titre abrégé: J Med Case Rep
Pays: England
ID NLM: 101293382
Informations de publication
Date de publication:
09 Jun 2024
09 Jun 2024
Historique:
received:
16
04
2024
accepted:
24
05
2024
medline:
9
6
2024
pubmed:
9
6
2024
entrez:
8
6
2024
Statut:
epublish
Résumé
Bradycardia, renal failure, atrioventricular (AV) node blocking, shock, and hyperkalemia syndrome is a potentially life-threatening clinical condition characterized by bradycardia, renal failure, atrioventricular (AV) node blocking, shock, and hyperkalemia. It constitutes a vicious circle in which the accumulation of pharmacologically active compounds and hyperkalemia lead to hemodynamic instability and heart failure. A 66-year-old Caucasian female patient was admitted to the emergency department presenting with fatigue and bradycardia. Upon examination, the patient was found to be anuric and hypotensive. Laboratory investigations revealed metabolic acidosis and hyperkalemia. Clinical evaluation suggested signs of digoxin toxicity, with serum digoxin concentrations persistently elevated over several days. Despite the implementation of antikalemic measures, the patient's condition remained refractory, necessitating renal dialysis and administration of digoxin immune fab. Bradycardia, renal failure, atrioventricular (AV) node blocking, shock, and hyperkalemia syndrome is a life-threatening condition that requires prompt management. It is important to also consider potential coexisting clinical manifestations indicative of intoxication from other pharmacological agents. Specifically, symptoms associated with the accumulation of drugs eliminated via the kidneys, such as digoxin. These manifestations may warrant targeted therapeutic measures.
Sections du résumé
BACKGROUND
BACKGROUND
Bradycardia, renal failure, atrioventricular (AV) node blocking, shock, and hyperkalemia syndrome is a potentially life-threatening clinical condition characterized by bradycardia, renal failure, atrioventricular (AV) node blocking, shock, and hyperkalemia. It constitutes a vicious circle in which the accumulation of pharmacologically active compounds and hyperkalemia lead to hemodynamic instability and heart failure.
CASE PRESENTATION
METHODS
A 66-year-old Caucasian female patient was admitted to the emergency department presenting with fatigue and bradycardia. Upon examination, the patient was found to be anuric and hypotensive. Laboratory investigations revealed metabolic acidosis and hyperkalemia. Clinical evaluation suggested signs of digoxin toxicity, with serum digoxin concentrations persistently elevated over several days. Despite the implementation of antikalemic measures, the patient's condition remained refractory, necessitating renal dialysis and administration of digoxin immune fab.
CONCLUSION
CONCLUSIONS
Bradycardia, renal failure, atrioventricular (AV) node blocking, shock, and hyperkalemia syndrome is a life-threatening condition that requires prompt management. It is important to also consider potential coexisting clinical manifestations indicative of intoxication from other pharmacological agents. Specifically, symptoms associated with the accumulation of drugs eliminated via the kidneys, such as digoxin. These manifestations may warrant targeted therapeutic measures.
Identifiants
pubmed: 38851740
doi: 10.1186/s13256-024-04600-5
pii: 10.1186/s13256-024-04600-5
doi:
Substances chimiques
Digoxin
73K4184T59
digoxin antibodies Fab fragments
0
Anti-Arrhythmia Agents
0
Immunoglobulin Fab Fragments
0
Types de publication
Case Reports
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
273Informations de copyright
© 2024. The Author(s).
Références
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