Chronic amitriptyline overdose in a child.

Amitriptyline, a tricyclic antidepressant, has a well-described toxicity profile, and acute ingestions are common in the pediatric toxicology world. However, little can be found in the literature regarding chronic overdose. We describe a case of a 6-year-old girl who was prescribed amitriptyline 30 mg nightly for sleep problems, but was mistakenly given 300 mg (15 mg/kg) nightly for over a month.

Systemic loxoscelism confirmation by bite-site skin surface: ELISA.

We report here a case of systemic loxoscelism, confirmed by bite-site skin surface swab. Features of systemic loxoscelism present in this case included debilitating symptoms, a classic local bite-site reaction, hemolysis causing loss of approximately 15% of the blood volume within 72 hours, and a symptomatic exanthem. A skin surface ELISA test was used to confirm the presence of venom.

Toxicity and use of over-the-counter cough and cold medication in the pediatric population.

Discussions of the efficacy and toxicity of over-the-counter cough and cold medication have been circulating in the pediatric literature for years. Adverse effects of these medications and the lack of evidence of their efficacy in children make their use a serious matter. An additional consideration for physicians is the recreational use of over-the-counter medications, including adolescent abuse of dextromethorphan.

24-hour provoked urine excretion test for heavy metals in children with autism and typically developing controls, a pilot study.

Introduction: The complementary and alternative medicine practice of prescribing chelators to children with autism is based on the premise that the chronic symptoms of autism can be ameliorated by reducing heavy metal body burden. However, there has not been definitive evidence, published to date, to support the assertion that children with autism are at increased risk of an excess chelatable body burden of heavy metals. The oral chelator meso-2,3-dimercaptosuccinic acid (DMSA) can be used diagnostically to mobilize heavy metals from extravascular pools, enhancing the identification of individuals who have a chelatable body burden.

Cytokines and toxicity in acetaminophen overdose.

Several cytokines have been reported to have hepatoprotective properties in animal models of acetaminophen toxicity. To investigate the relationships of cytokines and toxicity in acetaminophen overdose, blood samples were collected from patients following acute ingestions of acetaminophen. Samples for cytokine analysis were collected at the time of routine clinical monitoring in 111 patients (90 females; mean age 13.