Acute digoxin overdose in a newborn with renal failure: Use of digoxin immune fab and peritoneal dialysis

Matitiahu Berkovitch, Manjapra R. Akilesh, Rocco Gerace, Zul Verjee, Michael McGuigan, Hilary Whyte, Gideon Koren

Research output: Contribution to journalArticlepeer-review

Abstract

Digitalis intoxication is a common problem, mainly because of the narrow margin of safety of digoxin. These patients may have concomitant renal failure. In patients who have renal failure and who have been treated with digoxin-Fab, the elimination of the digoxin-Fab complex is significantly delayed, and there is a risk of dissociation of the complex with rebound of free digoxin and recurrence of toxicity. The high molecular weight of digoxin and digoxin-Fab complex prevents its elimination by hemodialysis or continuous arteriovenous hemofiltration. A 3-day-old newborn with digoxin overdose and acute renal failure was treated with digoxin immune Fab and peritoneal dialysis. Low levels of total digoxin were measured in the dialyzate, indicating poor elimination of the digoxin-Fab complex through peritoneal dialysis.

Original languageEnglish
Pages (from-to)531-533
Number of pages3
JournalTherapeutic Drug Monitoring
Volume16
Issue number5
DOIs
StatePublished - Oct 1994
Externally publishedYes

Keywords

  • Digitalis intoxication
  • Digoxin immune fab
  • Newborn
  • Peritoneal dialysis
  • Renal failure

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