Digoxin toxicity is still a possibility in any child on the medication. Therefore, a higher index of suspicion, with regular serum level estimations and possible dose readjustment should be considered in every child using the drug. Digoxin is no longer commonly used in the treatment of non-anaemic heart failure in children due to its toxicity. It is presently giving way to newer drugs like Angiotensin converting enzyme and Beta-adrenergic inhibitors in the management of congestive cardiac failure (CCF). The narrow margin between the therapeutic and toxic doses of digoxin remains a cause for concern. Female sex, lean body mass, extremes of age and renal insufficiency contribute to an increase in serum levels and toxicity. Reports in the literature of digoxin toxicity in children are very limited compared to adult cases, and any such case in a child ought to be documented to add to the sparse reviews. A 9-year-old girl with chronic kidney disease stage 5 (CKD-5) and heart failure developed digoxin toxicity recently. This manifested with bradycardia, prolonged PR interval, and 3rd degree heart block. Her serum digoxin level was 6.4ng/ml (normal reference is 0.8-2.0 ng/ml) at the time of the crises. She was managed with discontinuation of digoxin, intranasal oxygen, constant cardiac monitoring, haemodialysis and symptomatic treatment of electrolyte disturbances until the toxic crises resolved.
| Published in | American Journal of Pediatrics (Volume 8, Issue 4) |
| DOI | 10.11648/j.ajp.20220804.21 |
| Page(s) | 258-262 |
| Creative Commons |
This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited. |
| Copyright |
Copyright © The Author(s), 2022. Published by Science Publishing Group |
Children, Digoxin, Toxicity, Heart Failure, CKD-5
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APA Style
Nneka Chioma Okoronkwo, Cecil Levy. (2022). Digoxin Toxicity in a 9 Year Old Girl: A Case Report. American Journal of Pediatrics, 8(4), 258-262. https://doi.org/10.11648/j.ajp.20220804.21
ACS Style
Nneka Chioma Okoronkwo; Cecil Levy. Digoxin Toxicity in a 9 Year Old Girl: A Case Report. Am. J. Pediatr. 2022, 8(4), 258-262. doi: 10.11648/j.ajp.20220804.21
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Download@article{10.11648/j.ajp.20220804.21,
author = {Nneka Chioma Okoronkwo and Cecil Levy},
title = {Digoxin Toxicity in a 9 Year Old Girl: A Case Report},
journal = {American Journal of Pediatrics},
volume = {8},
number = {4},
pages = {258-262},
doi = {10.11648/j.ajp.20220804.21},
url = {https://doi.org/10.11648/j.ajp.20220804.21},
eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajp.20220804.21},
abstract = {Digoxin toxicity is still a possibility in any child on the medication. Therefore, a higher index of suspicion, with regular serum level estimations and possible dose readjustment should be considered in every child using the drug. Digoxin is no longer commonly used in the treatment of non-anaemic heart failure in children due to its toxicity. It is presently giving way to newer drugs like Angiotensin converting enzyme and Beta-adrenergic inhibitors in the management of congestive cardiac failure (CCF). The narrow margin between the therapeutic and toxic doses of digoxin remains a cause for concern. Female sex, lean body mass, extremes of age and renal insufficiency contribute to an increase in serum levels and toxicity. Reports in the literature of digoxin toxicity in children are very limited compared to adult cases, and any such case in a child ought to be documented to add to the sparse reviews. A 9-year-old girl with chronic kidney disease stage 5 (CKD-5) and heart failure developed digoxin toxicity recently. This manifested with bradycardia, prolonged PR interval, and 3rd degree heart block. Her serum digoxin level was 6.4ng/ml (normal reference is 0.8-2.0 ng/ml) at the time of the crises. She was managed with discontinuation of digoxin, intranasal oxygen, constant cardiac monitoring, haemodialysis and symptomatic treatment of electrolyte disturbances until the toxic crises resolved.},
year = {2022}
}
TY - JOUR T1 - Digoxin Toxicity in a 9 Year Old Girl: A Case Report AU - Nneka Chioma Okoronkwo AU - Cecil Levy Y1 - 2022/11/29 PY - 2022 N1 - https://doi.org/10.11648/j.ajp.20220804.21 DO - 10.11648/j.ajp.20220804.21 T2 - American Journal of Pediatrics JF - American Journal of Pediatrics JO - American Journal of Pediatrics SP - 258 EP - 262 PB - Science Publishing Group SN - 2472-0909 UR - https://doi.org/10.11648/j.ajp.20220804.21 AB - Digoxin toxicity is still a possibility in any child on the medication. Therefore, a higher index of suspicion, with regular serum level estimations and possible dose readjustment should be considered in every child using the drug. Digoxin is no longer commonly used in the treatment of non-anaemic heart failure in children due to its toxicity. It is presently giving way to newer drugs like Angiotensin converting enzyme and Beta-adrenergic inhibitors in the management of congestive cardiac failure (CCF). The narrow margin between the therapeutic and toxic doses of digoxin remains a cause for concern. Female sex, lean body mass, extremes of age and renal insufficiency contribute to an increase in serum levels and toxicity. Reports in the literature of digoxin toxicity in children are very limited compared to adult cases, and any such case in a child ought to be documented to add to the sparse reviews. A 9-year-old girl with chronic kidney disease stage 5 (CKD-5) and heart failure developed digoxin toxicity recently. This manifested with bradycardia, prolonged PR interval, and 3rd degree heart block. Her serum digoxin level was 6.4ng/ml (normal reference is 0.8-2.0 ng/ml) at the time of the crises. She was managed with discontinuation of digoxin, intranasal oxygen, constant cardiac monitoring, haemodialysis and symptomatic treatment of electrolyte disturbances until the toxic crises resolved. VL - 8 IS - 4 ER -
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