Lebensbedrohliche Theophyllin-Intoxikation im Rahmen eines Münchhausen-by-proxy-Syndroms

Zusammenfassung

Wir berichten über den Fall eines ehemaligen Frühgeborenen, der im Alter von 6 Monaten wegen Krampfanfällen stationär behandelt werden musste. Die Krampfanfälle bestanden trotz gebessertem EEG bei unterschiedlicher Behandlung fort. Es kam zu episodischen Hypokaliämien, Durchfällen und Tachykardien, die intensivmedizinische Maßnahmen erforderlich machten. Erst nach 3 Monaten kontinuierlicher Krankenhausbehandlung in drei unterschiedlichen Kliniken wurde eine Theophyllin-Intoxikation als Ursache diagnostiziert, die durch die mit aufgenommene Mutter herbeigeführt wurde. Die Toxizität von Theophyllin ist bekannt. Therapieassoziierte Nebenwirkungen sind nicht selten. Es existieren zahlreiche Berichte über Theophyllin-Intoxikationen in suizidaler Absicht. Eine vorsätzliche Vergiftung mit Theophyllin im Zusammenhang mit Münchhausen-by-proxy-Syndrom ist noch nicht beschrieben worden.

Summary

We report of a prematurely born infant, who was admitted to hospital at the age of 6 months due to seizures. The seizures continued despite of an improved electroencephalogramm due to varying medications. The boy had episodes of hypokaliaemia, diarrhea, and tachycardia which were treated in critical care unit. Not before 3 months of continued treatment and diagnostic work up in three different hospitals had passed the underlying poisoning with theophylline by the mother was proved. The toxicity of theophylline is well known. Adverse reactions occur frequently during theophylline therapy. There are numerous reports of suicidal intoxications with theophylline. Non-accidential poisoning with theophylline has not yet been reported in the context of Munchausen syndrome by proxy.

Schlüsselwörter

Krampfanfälle - Hypokaliämie - Münchhausen-by-proxy-Syndrom - Theophyllin

Key words

Seizures - hypokaliaemia - Munchausen syndrome by proxy - theophylline

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