Perindopril overdose
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Acute pancreatitis and hypotension: case report A 15-year-old girl developed hypotension and acute pancreatitis following an overdose and intoxication of perindopril for suicidal purpose. The girl presented to the emergency department in Turkey within 30 minutes of taking 10 tablets of 5mg perindopril in an attempt to suicide [route not stated]. Gastric lavage was performed, and parts of the pills were seen in the lavage fluid. On admission, she was hypotensive. Later, serum bolus was administered, and her blood pressure remained normal. She had neither any family history nor the use of any alcohol or illegal substances. Physical examination was normal, and no pathological results were observed from haemograms, biochemistry test and blood gas test. Six hours following the drug intake, she developed nausea, vomiting and severe upper abdominal pain. A significant increase in amylase level and a slight increase in lipase level was observed at the 6th and 12th hour of drug intake. Transaminase level, electrolytes, kidney function tests and blood lipid levels were found within the normal range. Abdominal ultrasonography revealed a large, hypoechoic and irregular border of the corpus of the pancreas, which was consistent with pancreatitis. She was diagnosed with acute pancreatitis secondary to overdose and intoxication of perindopril. The girl’s food intake was stopped, and she was administered intravenous hydration. In the emergency department, she exhibited severe pain, for which, paracetamol was given. However, no severe pain was observed in the pediatric intensive care unit. At the 24th hour of drug intake, amylase and lipase levels decreased. At the 48th hour, her clinical symptoms were improved, and she was initiated on enteral nutrition. On the 3rd day, amylase and lipase levels were found 221 U/L and 33 U/L respectively with no active complaints. She was discharged at the end of the first week. On follow-up, no complications secondary to pancreatitis were observed. Misirlioglu M, et al. A rare cause of pediatric acute pancreatitis: Perindopril intoxication. Turkish Journal of Emergency Medicine 20: 199-201, No. 4, 07 Oct 2020. Available 803515683 from: URL: http://doi.org/10.4103/2452-2473.297465
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Reactions 21 Nov 2020 No. 1831
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