Document Detail


Serotonin syndrome induced by tramadol intoxication in an 8-month-old infant.
MedLine Citation:
PMID:  21147393     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Severe cases of pediatric tramadol intoxication are rarely reported. We report on serotonin syndrome after tramadol intoxication. An 8-month-old girl developed extreme agitation after accidentally ingesting a tablet of her father's medication (Monocrixo LP (Thérabel Lucien Pharma, Levallois Perret, France), 200 mg tramadol). Unable to sleep, she was admitted the next morning to our Pediatric Emergency Department after an episode of epistaxis. Vital signs were significant for sinus tachycardia and a neurologic examination revealed intermediately reactive pupils, agitation alternating with drowsiness with a Glasgow Coma Scale of 10, and increased lower-limb reflexes. Within 24 hours, she developed hyperthermia and high blood pressure. She did not experience seizures. Neurologic and cardiovascular effects resolved on day 2. Tramadol serum plasma levels confirmed the intoxication (680 μg/L). She was discharged on day 5 with no sequelae. Serotonin syndrome was described in adults when tramadol was associated with selective serotonin-reuptake inhibitors in contexts of therapy or intoxication. Our patient developed moderate serotonin syndrome. The clinical presentation was unusual compared with previous pediatric cases of tramadol intoxication, in which opioid effects and seizures were usually predominant. This case illustrates that serotonin syndrome can occur in children intoxicated with tramadol.
Authors:
Céline Maréchal; Raphaele Honorat; Isabelle Claudet
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Pediatric neurology     Volume:  44     ISSN:  1873-5150     ISO Abbreviation:  Pediatr. Neurol.     Publication Date:  2011 Jan 
Date Detail:
Created Date:  2010-12-14     Completed Date:  2011-04-01     Revised Date:  2012-03-28    
Medline Journal Info:
Nlm Unique ID:  8508183     Medline TA:  Pediatr Neurol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  72-4     Citation Subset:  IM    
Copyright Information:
Copyright © 2011 Elsevier Inc. All rights reserved.
Affiliation:
Pediatric Emergency Department, Children's Hospital, Toulouse, France.
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MeSH Terms
Descriptor/Qualifier:
Analgesics, Opioid / blood,  poisoning*
Epistaxis / etiology
Female
Fever / chemically induced
Glasgow Coma Scale
Hemodynamics / physiology
Humans
Infant
Reflex / drug effects
Seizures / chemically induced
Serotonin Syndrome / etiology*,  physiopathology,  therapy
Tramadol / blood,  poisoning*
Chemical
Reg. No./Substance:
0/Analgesics, Opioid; 27203-92-5/Tramadol
Comments/Corrections
Comment In:
Pediatr Neurol. 2012 Mar;46(3):199; author reply 199   [PMID:  22353303 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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