Massive Nonfatal Hydroxychloroquine Ingestion in a Pediatric Patient

Background: Hydroxychloroquine overdose is rare but potentially lethal. Hydroxychloroquine overdose symptoms are characterized by central nervous system toxicity, cardiac toxicity, and hypokalemia. Recommended treatment consists of epinephrine, high-dose diazepam, and careful potassium repletion. Few pediatric hydroxychloroquine overdoses have been reported. Case Report: We describe a 14-year-old girl who ingested 10 g (172 mg/kg) of hydroxychloroquine. She developed tachycardia, hypotension, and hypokalemia. She was intubated and treated with diazepam and epinephrine infusions and potassium supplementation. Her serum hydroxychloroquine concentration obtained 10 h after ingestion was 13,000 ng/mL (reference range 500-2000 ng/mL). The patient made a full medical recovery. Why Should an Emergency Physician Be Aware of This?: Pediatric hydroxychloroquine overdoses are reported rarely, and the toxic and lethal doses of hydroxychloroquine ingestion have not been established. This case of a teenaged patient who ingested 10 g of hydroxychloroquine and survived provides additional information that may be used to help establish toxic and lethal doses of ingestion. (C) 2021 Elsevier Inc. All rights reserved.

Automated summary

Hydroxychloroquine overdose is rare but potentially lethal, characterized by central nervous system and cardiac toxicity, as well as hypokalemia. This case report of a 14-year-old girl who ingested 10 g of hydroxychloroquine and survived provides additional information for establishing the toxic and lethal doses of hydroxychloroquine ingestion.