Correlation between theophylline level and troponin I versus kinase MB as predictor markers of the severity and outcomes in acute theophylline toxicity in adults

Document Type : Original Article

Authors

1 forensic medicine and clinical toxicology department, Ain Shams University

2 Forensic medicine and clinical toxicology department, Ain Shams University

Abstract

Background: Theophylline, a methylxanthine, remains commonly used in several countries to manage both acute and chronic bronchial asthma. It remains popular due to its effectiveness, affordability, and widespread availability. Acute theophylline toxicity remains a significant hazard due to the absence of a specific antidote. There is a significant need to predict the severity and outcomes of patients with acute theophylline poisoning to guide appropriate treatment. Methods: This prospective cohort study included 34 patients admitted to the Poison Control Center at Ain Shams University Hospitals (PCC-ASUH) over a 6-month period from January to June 2022 with a history of acute theophylline poisoning. Troponin I and creatine kinase-MB levels were assessed at 6 and 12 hours after admission. Results showed that troponin I levels at 6 and 12 hours post ingestion, along with creatine kinase-MB levels at 12 hours, were significantly elevated in patients with severe acute theophylline poisoning and in those who required intensive care unit admission and hemodialysis. Conclusion: Troponin I can predict severity, need for ICU admission, and hemodialysis in acute theophylline poisoning regardless of early or delayed presentation, while CK-MB may serve as a predictor in patients presenting late. Recommendation: Troponin is recommended as a predictor of severity in acute intoxicated patients in early and delayed presentation. CKMB use as a predictor of severity in acute intoxicated patients in delayed presentation.

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