Prediction of the Severity of Acute Theophylline Toxicity in Patients Admitted to Zagazig University Hospitals | ||
| Zagazig University Medical Journal | ||
| Volume 31, Issue 8, August 2025, Pages 4239-4250 PDF (1.53 M) | ||
| Document Type: Original Article | ||
| DOI: 10.21608/zumj.2025.382511.3936 | ||
| Authors | ||
| Samar Sakr1; Esraa Mohamed Elsayed Ali* 1; Ahmed Omar1; Fatma Ibrahim2 | ||
| 1Forensic Medicine and Clinical Toxicology Department, Faculty of Medicine, Zagazig University, Egypt | ||
| 2Forensic Medicine and Clinical Toxicology Department Faculty of Medicine, Zagazig University | ||
| Abstract | ||
| Background: In many developing countries, theophylline and its derivatives are commonly prescribed for managing acute and chronic asthma due to affordability, accessibility, and efficacy. Theophylline has a narrow therapeutic index and yields poor outcomes in severe cases, necessitating reliable predictors of the severity of acute poisoning. So, we aimed to identify predictors of the severity of acute theophylline toxicity in patients admitted to Zagazig University Hospitals. Methods: This prospective cohort study included 45 patients of acute theophylline poisoning who presented to Zagazig University Hospitals from June 2023 to June 2024. All included patients underwent socio-demographic and toxicological data collection, careful clinical examination, laboratory investigations, and determination of theophylline levels. Patients were scored according to the Poison Severity Score (PSS). Results: Most cases were females from rural areas with a median age of 19, who mostly committed suicide using oral sustained-release preparations. Based on PSS, patients were graded as minor (15.6%), moderate (71.1%), and severe (13.3%). Nausea and vomiting were the commonest presentations (93.3%), while sinus tachycardia was the most detected dysrhythmia (91.1%). Almost all severe cases had hypotension and seizures (83.3%). A statistically significant positive correlation was established between the severity of cases as per PSS and dose, duration till admission, glucose/potassium (G/K+) ratio, troponin I, creatinine kinase-MB (CK-MB), and serum theophylline level. Meanwhile, the severity of patients negatively correlated with serum K+, bicarbonate (HCO3-), and pH. Conclusion: Theophylline level, troponin I, pH, G/K+ ratio, and CK-MB can be utilized as reliable predictors of the severity of acute theophylline toxicity. | ||
| Keywords | ||
| Theophylline; Toxicity; Severity; PSS; G/K ratio | ||
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