Nonketotic hyperglycemic coma in toddlers after unintentional methadone ingestion

Ann Emerg Med. 2006 Oct;48(4):448-51. doi: 10.1016/j.annemergmed.2006.02.023. Epub 2006 Apr 19.

Abstract

Methadone overdoses are increasing in parallel with the increased frequency of opiate substitution therapy in adults. Although unintentional methadone intoxication in children is rare, it is becoming more frequently recognized. We report 3 cases of unintentional methadone overdose in toddlers who initially displayed central nervous system depression associated with severe nonketotic hyperglycemia and discuss the possible pathophysiologic mechanisms of an underrecognized symptom of opiate intoxication in young children.

Publication types

  • Case Reports

MeSH terms

  • Accidents, Home*
  • Animals
  • Brain Damage, Chronic / etiology
  • Child, Preschool
  • Diabetes Mellitus, Type 1 / diagnosis
  • Diagnostic Errors*
  • Dobutamine / therapeutic use
  • Drug Packaging
  • Epinephrine / therapeutic use
  • Female
  • France
  • Humans
  • Hyperglycemic Hyperosmolar Nonketotic Coma / chemically induced*
  • Hyperglycemic Hyperosmolar Nonketotic Coma / complications
  • Hyperglycemic Hyperosmolar Nonketotic Coma / diagnosis
  • Hyperglycemic Hyperosmolar Nonketotic Coma / drug therapy
  • Infant
  • Insulin / therapeutic use
  • Islets of Langerhans / drug effects
  • Islets of Langerhans / physiopathology
  • Male
  • Methadone / pharmacology
  • Methadone / poisoning*
  • Mice
  • Multiple Organ Failure / etiology
  • Myocardial Infarction / etiology
  • Naloxone / therapeutic use
  • Receptor, Insulin / drug effects
  • Receptors, Opioid, mu / drug effects
  • Receptors, Opioid, mu / physiology
  • Shock, Cardiogenic / etiology
  • Sweetening Agents
  • Time Factors

Substances

  • Insulin
  • Receptors, Opioid, mu
  • Sweetening Agents
  • Naloxone
  • Dobutamine
  • Receptor, Insulin
  • Methadone
  • Epinephrine