Encefalopatía, convulsiones e hipopotasemia en la intoxicación teofílínica: Análisis de un caso

Suárez Ortega, S.; Rodríguez Perdomo, E.; Parrilla Díaz, J.; Ayala Galán, E.; Artiles Vizcaíno, J.; Melado Sánchez, P.

doi:10.1016/S0300-2896(15)30905-4

Archivos de Bronconeumología

ISSN: 0300-2896

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Vol. 31. Issue 7.

Pages 368-370 (October 1995)

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Pages 368-370 (October 1995)

DOI: 10.1016/S0300-2896(15)30905-4

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Encefalopatía, convulsiones e hipopotasemia en la intoxicación teofílínica: Análisis de un caso

Encephalopathy, convulsions and hypokaliemia in theophylline intoxication. A case report

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S. Suárez Ortega*,1, E. Rodríguez Perdomo**, J. Parrilla Díaz**, E. Ayala Galán**, J. Artiles Vizcaíno*, P. Melado Sánchez*

* Servicio de Medicina Interna. Complejo Hospitalario Las Palmas Norte. Hospitales Nuestra Señora del Pino y El Sabinal. Carretera General de Marzagán. Las Palmas de Gran Canaria

** Servicio de Neumología. Complejo Hospitalario Las Palmas Norte. Hospitales Nuestra Señora del Pino y El Sabinal. Carretera General de Marzagán. Las Palmas de Gran Canaria

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Un varón de 73 años ingresó en nuestro hospital tras presentar crisis convulsiva, precedida de encefalopatía de una semana de evolución. Tenía historia de enfermedad pulmonar obstructiva crónica de larga evolución. La analítica demostró hipopotasemia, alcalosis respiratoria y niveles tóxicos de teofilinemia. Se comenta la gravedad de las convulsiones y arritmias y la elevada incidencia de hipopotasemia en la intoxicación teofílínica. Se discute el papel de la hipopotasemia en la patogenia de las convulsiones, y la elevada letalidad de las mismas en dicha intoxicación. Se mencionan otros posibles mecanismos patogénicos de la encefalopatía teofílínica y la discutida utilización de la teofílina de forma continua en la enfermedad pulmonar obstructiva crónica.

Palabras clave:

Teofílina

Intoxicación

Convulsiones

Hipopotasemia

EPOC

A 73 year -old man was admitted to our hospital after convulsive seizures preceded by encephalopathy lasting one week. He had a history of long-standing chronic obstructive pulmonary disease and analysis showed hypokaliemia, respiratory alkalosis and toxic levels of theophylline. We discuss the severity of the convulsions and arrhythmias, the high incidence of hypokaliemia in theophylline poisoning, as well as the role of hypokaliemia in the pathogenesis of the convulsions and the high level of mortality in this type of intoxication. Other possible mechanisms involved in theophylline encephalopathy are mencioned, along with the controversial use of theophylline for continuous treatment of chronic obstructive pulmonary disease.

Key words:

Theophylline

intoxication

convulsions

hypokaliemia

COPD

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