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Severe digoxin intoxication in a child treated by infusion of digoxin-specific Fab-antibody-fragments

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Abstract

Accidental digitalis ingestion in children is a rare, but potentially life-threatening emergency.

We report the case of a 210/12-year-old boy with accidental ingestion of 6 mg β-Acetyl-digoxin. Soon after admission, the boy developed sinus bradycardia, SA and AV-block, of increasing severity without circulatory impairment. As the serum digoxin level reached 21.7 ng/ml digoxin-specific Fab-antibody-fragments were used to bind free serum digoxin. Immediately after infusion, serum free digoxin was below the detection limit, whereas total digoxin peaked at 219 ng/ml 5 h thereafter. The arrhytmias did not subside totally, so that in addition, a transvenous pacemaker was placed, but never used.

The antibody-infusion was well tolerated and the boy was discharged in good health.

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Rossi, R., Leititis, J.U., Hagel, K.J. et al. Severe digoxin intoxication in a child treated by infusion of digoxin-specific Fab-antibody-fragments. Eur J Pediatr 142, 138–140 (1984). https://doi.org/10.1007/BF00445597

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  • DOI: https://doi.org/10.1007/BF00445597

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