Faculty Collaboration Database

Chloroquine poisoning in a child. Ann Emerg Med 1990 Jan;19(1):47-50

Date

01/01/1990

Pubmed ID

2297155

DOI

10.1016/s0196-0644(05)82141-9

Scopus ID

2-s2.0-0025014660 (requires institutional sign-in at Scopus site)   34 Citations

Abstract

Chloroquine poisoning in children, although infrequent, is extremely dangerous because of the narrow margin between therapeutic and toxic doses. Children clinically present with apnea, seizures, and cardiac arrhythmias. We present the case of a 12-month-old infant, the second-youngest patient reported in the US literature to die from chloroquine poisoning. A serum level of 4.4 mg/L (13.64 mumol/L) was obtained after the infant ingested only one tablet (300 mg). This establishes a new minimal lethal dose/blood level for children. Although some pediatric and adult pharmacokinetic and clinical similarities exist, the outcome is different. Pediatric mortality is 80%, whereas adult mortality is only 10%. Pediatric ingestion cases are primarily unintentional, and most adult cases are suicide attempts. Current treatment in adults includes a protocol of diazepam and epinephrine. Further studies involving children and these medications and other modalities are needed to improve survival.

Author List

Kelly JC, Wasserman GS, Bernard WD, Schultz C, Knapp J

Author

Christopher J. Schultz MD Chair, Professor in the Radiation Oncology department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Apnea
Arrhythmias, Cardiac
Chloroquine
Female
Humans
Infant
Poisoning
Seizures