[A clinical review of patients with convulsions during theophylline administration II: points to consider in administration and prognosis as determined in patients with theophyline toxicosis].

OBJECTIVE

To discover features of patients with theophylline toxicosis among patients who developed convulsions during theophylline administration.

METHODS

Fifteen patients, whose measured or estimated blood theophylline concentration at the time of convulsion development was >/=40 microg/mL, were extracted out of 334 patients who were reported between October 1987 and April 2004 and who developed convulsions during theophylline administration (oral theophylline: 255 patients; intravenous theophylline: 79 patients). Patient background, state of drug administration, blood theophylline concentration, presence or absence of status epilepticus, and outcome were examined.

RESULTS

Young children and children with fever were predominant, and eight of 15 patients had both features. Furthermore, the dose exceeded the currently recommended target dose in most of patients whose given dose is known. Patients with misdispensing and patients having problems with administration and ingestion methods were included in them. Outcomes included one case of death, two cases of sequelae, 11 cases of recovery or alleviation, and 1 case of unknown. The patient who died took large doses of theophylline, and both of two patients who had sequelae had fever associated with an infection.

CONCLUSIONS

Our study revealed 1) heed should be given to the age of the affected child and to theophylline administration when fever is present in order to avoid theophylline toxicosis and 2) many patients with the toxicosis (11/15) present a relatively favorable prognosis.