Document Detail


Accidental ten times overdose administration of recombinant human erythropoietin (rh-EPO) up to 318,000 units a day in acute myocardial infarction: report of two cases.
MedLine Citation:
PMID:  16445599     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The cytokine erythropoietin protects the heart from ischaemic injury, in part by preventing apoptosis. But appropriate dose of erythropoietin for the protection of injured heart has not been studied. While we were researching the cardiac protective effects of erythropoietin in acute myocardial infarction, we experienced two cases of accidental nearly ten times overdose administration of erythropoietin up to 318,000 units instead of 33,000 units on the second day of three scheduled days of treatment. So a total of 384,000 units of erythropoietin were administered during three days. In case 1, the ALT level soared up to 386 U/l on the second day of administration and decreased slowly. It was back to normal state 3 months later. The AST level increased slowly up to 391 U/l and normalized 3 months later. Haemoglobin level was elevated up to 15.7 g/dl (14.7 g/dl at admission) and, 3 months later, normalized to 14.8 g/dl. In case 2, the ALT level was elevated up to 98 U/l on the second day of administration and decreased slowly. Three months later, the ALT level was normalized. The AST level also increased slowly up to 71 U/l and normalized 3 months later. Haemoglobin level was elevated up to 15.6 g/dl (13.8 g/dl at admission) and, 3 months later, normalized to 13.6 g/dl. In these two cases reported, these patients, even after massive overdose, tolerated it relatively well and the only side-effects we found were elevated liver enzyme and haemoglobin levels.
Authors:
Dae-Hee Shin; Young-Il Kwon; Sung-Il Choi; Ui-Soon Park; Je Lee; Jin-Ho Shin; Jae-Ung Lee; Soon-Gil Kim; Jeong-Hyun Kim; Heon-Kil Lim; Bang-Hun Lee; Kyung-Soo Kim
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Basic & clinical pharmacology & toxicology     Volume:  98     ISSN:  1742-7835     ISO Abbreviation:  Basic Clin. Pharmacol. Toxicol.     Publication Date:  2006 Feb 
Date Detail:
Created Date:  2006-01-31     Completed Date:  2006-07-07     Revised Date:  2006-10-30    
Medline Journal Info:
Nlm Unique ID:  101208422     Medline TA:  Basic Clin Pharmacol Toxicol     Country:  Denmark    
Other Details:
Languages:  eng     Pagination:  222-4     Citation Subset:  IM    
Affiliation:
Cardiology Division, Hanyang University College of Medicine, Seoul, Korea.
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MeSH Terms
Descriptor/Qualifier:
Adult
Alanine Transaminase / blood
Aspartate Aminotransferases / blood
Erythropoietin, Recombinant / adverse effects*,  therapeutic use
Hemoglobins / analysis
Humans
Liver / drug effects,  enzymology
Male
Middle Aged
Myocardial Infarction / drug therapy*,  enzymology
Overdose
Chemical
Reg. No./Substance:
0/Erythropoietin, Recombinant; 0/Hemoglobins; EC 2.6.1.1/Aspartate Aminotransferases; EC 2.6.1.2/Alanine Transaminase

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