Work

Early Cessation of Renal Replacement Therapy in Theophylline Toxicity: A Case Report With Literature Review

Year: 2025

Type: article

Abstract: Theophylline toxicity often results in severe neurological and cardiovascular complications and may require renal replacement therapy (RRT) in life-threatening situations. However, guidance on when it is safe to discontinue RRT remains limited. We report the case of an 85-year-old woman who developed status epilepticus following theophylline overdose, with a peak serum level of 119.8 mg/L. She was initially hemodynamically unstable and received continuous hemodiafiltration (CHDF). After clinical stabilization and a reduction in serum theophylline to 24.7 mg/L, CHDF was discontinued despite mild tachycardia and low-dose catecholamine use. The patient remained stable without rebound toxicity and recovered uneventfully. This case highlights that early discontinuation of RRT may be feasible even when theophylline levels exceed traditional thresholds, provided there is sustained clinical improvement, including stability despite mild tachycardia and low-dose catecholamine support.

Source: Cureus

DOI: 10.7759/cureus.88081

Authors: Shungo Kakiuchi, Haruki Mizuno, Kanako Irei, Minoru Hayashi

Institution: Fukui Prefectural Hospital

Language: English

Topic: Poisoning and overdose treatments

Subfield: Emergency Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: diamond

OpenAlex ID: W4412478689