Serious diphenhydramine overdose treated with hemodialysis: A case report

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  • SUZUKI Keisuke
    Department of Emergency Disaster and Critical Care  Medicine, Showa University School of Medicine
  • KATO Akihito
    Department of Emergency Disaster and Critical Care  Medicine, Showa University School of Medicine
  • KAIZAKI-MITSUMOTO Asuka
    Division of Toxicology, Department of Pharmacology, Toxicology and Therapeutics, Showa University School of Pharmacy
  • NUMAZAWA Satoshi
    Division of Toxicology, Department of Pharmacology, Toxicology and Therapeutics, Showa University School of Pharmacy
  • INOUE Gen
    Department of Emergency Disaster and Critical Care  Medicine, Showa University School of Medicine
  • NAKAJIMA Yasuhiro
    Department of Emergency Disaster and Critical Care  Medicine, Showa University School of Medicine
  • MAEDA Atsuo
    Department of Emergency Disaster and Critical Care  Medicine, Showa University School of Medicine
  • MORIKAWA Kentaro
    Department of Emergency Disaster and Critical Care  Medicine, Showa University School of Medicine
  • YAGI Masaharu
    Department of Emergency Disaster and Critical Care  Medicine, Showa University School of Medicine
  • DOHI Kenji
    Department of Emergency Disaster and Critical Care  Medicine, Showa University School of Medicine

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Other Title
  • 血液透析を施行した重症ジフェンヒドラミン中毒の1例
  • 症例・事例報告 血液透析を施行した重症ジフェンヒドラミン中毒の1例
  • ショウレイ ・ ジレイ ホウコク ケツエキ トウセキ オ シコウ シタ ジュウショウ ジフェンヒドラミン チュウドク ノ 1レイ

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Abstract

<p>Diphenhydramine is widely used as an anti-allergy medication, cold preparation, and sleeping aid. We report a case in which the blood level of diphenhydramine was measured in the course of treatment and was shown to be 4,990 mg. A 22-year-old woman presented to our emergency department with a disturbance in consciousness, nystagmus, and convulsions. We suspected diphenhydramine poisoning because Restamin U Kowa tablets had been found in her belongings. She was admitted to the critical care unit, where she was mechanically ventilated and underwent hemodialysis. She was extubated on the 4th day, was lucid. She recovered without complications and was discharged from the hospital on the 8th day. The blood diphenhydramine level suggested that diphenhydramine was removed not only by renal excretion but also by hemodialysis, which was normally considered ineffective. Therefore  treatment with hemodialysis may be considered in serious diphenhydramine overdose.</p>

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