TY - JOUR
T1 - Respiratory alkalosis and metabolic acidosis in a child treated with sulthiame
AU - Weissbach, Avichai
AU - Tirosh, Irit
AU - Scheuerman, Oded
AU - Hoffer, Vered
AU - Garty, Ben Zion
PY - 2010/10
Y1 - 2010/10
N2 - Objectives: To report on severe acid-base disturbance in a child with symptomatic epilepsy treated with sulthiame. Results: A 9.5-year-old boy with chronic generalized tonic-clonic seizures was treated with carbamazepine and valproic acid. Because of poor seizure control, sulthiame was added to the treatment. Two months later, he presented at the emergency department with severe weakness, headache, dizziness, dyspnea, anorexia, and confusional state. Arterial blood gas analysis showed mixed respiratory alkalosis with high anion gap metabolic acidosis. Sulthiame-induced acid-base disturbance was suspected. The drug was withheld for the first 24 hours and then restarted at a reduced dosage. The arterial blood gases gradually normalized, the confusion disappeared, and the patient was discharged home.Three months later, 4 weeks after an increase in sulthiame dosage, the patient was once again admitted with the same clinical picture. Improvement was noted after the drug dosage was reduced. Conclusions: This is the first report of mixed respiratory alkalosis and metabolic acidosis in a child treated with sulthiame. Monitoring of the acid-base status should be considered in patients treated with sulthiame.
AB - Objectives: To report on severe acid-base disturbance in a child with symptomatic epilepsy treated with sulthiame. Results: A 9.5-year-old boy with chronic generalized tonic-clonic seizures was treated with carbamazepine and valproic acid. Because of poor seizure control, sulthiame was added to the treatment. Two months later, he presented at the emergency department with severe weakness, headache, dizziness, dyspnea, anorexia, and confusional state. Arterial blood gas analysis showed mixed respiratory alkalosis with high anion gap metabolic acidosis. Sulthiame-induced acid-base disturbance was suspected. The drug was withheld for the first 24 hours and then restarted at a reduced dosage. The arterial blood gases gradually normalized, the confusion disappeared, and the patient was discharged home.Three months later, 4 weeks after an increase in sulthiame dosage, the patient was once again admitted with the same clinical picture. Improvement was noted after the drug dosage was reduced. Conclusions: This is the first report of mixed respiratory alkalosis and metabolic acidosis in a child treated with sulthiame. Monitoring of the acid-base status should be considered in patients treated with sulthiame.
KW - metabolic acidosis
KW - respiratory alkalosis
KW - sulthiame
UR - http://www.scopus.com/inward/record.url?scp=77958526378&partnerID=8YFLogxK
U2 - 10.1097/PEC.0b013e3181f39b4b
DO - 10.1097/PEC.0b013e3181f39b4b
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C2 - 20930598
AN - SCOPUS:77958526378
SN - 0749-5161
VL - 26
SP - 752
EP - 753
JO - Pediatric Emergency Care
JF - Pediatric Emergency Care
IS - 10
ER -