Annals of Emergency Medicine
Volume 48, Issue 4 , Pages 448-451, October 2006

Nonketotic Hyperglycemic Coma in Toddlers After Unintentional Methadone Ingestion

  • Sinan Tiras, MD

      Affiliations

    • Intensive Care Unit, Department of Pediatrics, Bicetre Hospital, Le Kremlin-Bicêtre, France
    • ,
  • Vincent Haas, MD

      Affiliations

    • Intensive Care Unit, Department of Pediatrics, Bicetre Hospital, Le Kremlin-Bicêtre, France
    • ,
  • Laurent Chevret, MD

      Affiliations

    • Intensive Care Unit, Department of Pediatrics, Bicetre Hospital, Le Kremlin-Bicêtre, France
    • ,
  • Marion Decobert, MD

      Affiliations

    • Pediatric Emergency Services, Department of Pediatrics, Bicetre Hospital, Le Kremlin-Bicêtre, France
    • ,
  • Anne Buisine, MD

      Affiliations

    • Biological Toxicology Laboratory, Lariboisière Hospital, Paris, France.
    • ,
  • Denis Devictor, MD

      Affiliations

    • Intensive Care Unit, Department of Pediatrics, Bicetre Hospital, Le Kremlin-Bicêtre, France
    • ,
  • Philippe Durand, MD

      Affiliations

    • Intensive Care Unit, Department of Pediatrics, Bicetre Hospital, Le Kremlin-Bicêtre, France
    • ,
  • Pierre Tissières, MD

      Affiliations

    • Intensive Care Unit, Department of Pediatrics, Bicetre Hospital, Le Kremlin-Bicêtre, France
    • Corresponding Author InformationAddress for correspondence: Pierre Tissieres, MD, ICU Laboratory 7-198, Department of Microbiology and Molecular Medicine, University of Geneva Medical School, CMU-Rue Michel-Servet 1, 1211 Geneva 4, Switzerland; +41-22-3795686

Received 16 August 2005; received in revised form 26 January 2006 and 21 February 2006; accepted 22 February 2006. published online 21 April 2006.

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.

 

 Supervising editor: G. Randall Bond, MDFunding and support: The authors report this study did not receive any outside funding or support.Reprints not available from the authors.

PII: S0196-0644(06)00308-8

doi:10.1016/j.annemergmed.2006.02.023

Annals of Emergency Medicine
Volume 48, Issue 4 , Pages 448-451, October 2006