Ibuprofen overdose

Reactions 1464, p25 - 10 Aug 2013

O SIbuprofen overdose

Syndrome of inappropriate diuresis: case reportA 30-year-old woman developed syndrome of inappropriate

diuresis after an overdose of ibuprofen.The woman was admitted to an emergency department with

fever and nausea. Blood tests showed a moderatehyponatraemia (132 mmol/L), while other biological valueswere within the normal ranges. The following day shecomplained of headache, nausea and diffuse pain similar tomeningism. An EEG revealed signs of encephalopathy, andbiochemistry tests showed a serum sodium level of113 mmol/L, and an osmolality of 239 mOsm/L.

The woman was administered normal saline andpresumptive anti-infective treatment with amoxicillin, aciclovirand ceftriaxone. She experienced a seizure, and was moved tothe ICU. Her serum sodium level fell to 105 mmol/L on day 3.Fluid restriction was initiated, and in 24 hours her serumsodium had risen to 124 mmol/L. However, while herneurological disorders were abating, she developed acuterenal failure, necessitating withdrawal of fluid restriction. Onday 6, her renal function was restored, and her serum sodiumlevel had reached 132 mmol/L. Additional investigationsuncovered the fact that she had ingested more than 20 tabletsof ibuprofen 400mg (representing 152 mg/kg) to treat backpain 2 days prior to admission. She was discharged 12 dayslater after achieving a favourable outcome.

Author comment: "Ibuprofen-induced [syndrome ofinappropriate diuresis] was the most likely diagnosis. . . [T]hescore was five [using Naranjo criteria], so the adverse drugreaction was classified as probable".Roche C, et al. Ibuprofen can induce syndrome of inappropriate diuresis in healthyyoung patients. Case Reports in Medicine 2013: No. 167267, 2013. Availablefrom: URL: http://dx.doi.org/10.1155/2013/167267 - France 803091259

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Reactions 10 Aug 2013 No. 14640114-9954/13/1464-0001/$14.95 Adis © 2013 Springer International Publishing AG. All rights reserved