Not only Van Gogh: a case of BRASH syndrome with concomitant digoxin toxicity

Autor: Ilaria Costantini, Giovanni Mantelli, Massimo Carollo, Lorenzo Losso, Elia Morando, Matilde Bacchion, Mariapaola Castri, Lucia Drezza, Giorgio Ricci
Jazyk: angličtina
Rok vydání: 2024
Předmět:
Zdroj: Journal of Medical Case Reports, Vol 18, Iss 1, Pp 1-7 (2024)
Druh dokumentu: article
ISSN: 1752-1947
49909843
DOI: 10.1186/s13256-024-04600-5
Popis: Abstract Background Bradycardia, renal failure, atrioventricular (AV) node blocking, shock, and hyperkalemia syndrome is a potentially life-threatening clinical condition characterized by bradycardia, renal failure, atrioventricular (AV) node blocking, shock, and hyperkalemia. It constitutes a vicious circle in which the accumulation of pharmacologically active compounds and hyperkalemia lead to hemodynamic instability and heart failure. Case presentation A 66-year-old Caucasian female patient was admitted to the emergency department presenting with fatigue and bradycardia. Upon examination, the patient was found to be anuric and hypotensive. Laboratory investigations revealed metabolic acidosis and hyperkalemia. Clinical evaluation suggested signs of digoxin toxicity, with serum digoxin concentrations persistently elevated over several days. Despite the implementation of antikalemic measures, the patient’s condition remained refractory, necessitating renal dialysis and administration of digoxin immune fab. Conclusion Bradycardia, renal failure, atrioventricular (AV) node blocking, shock, and hyperkalemia syndrome is a life-threatening condition that requires prompt management. It is important to also consider potential coexisting clinical manifestations indicative of intoxication from other pharmacological agents. Specifically, symptoms associated with the accumulation of drugs eliminated via the kidneys, such as digoxin. These manifestations may warrant targeted therapeutic measures.
Databáze: Directory of Open Access Journals
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