{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,4]],"date-time":"2025-05-04T18:40:10Z","timestamp":1746384010900,"version":"3.40.4"},"reference-count":62,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Pediatr Emer Care"],"published-print":{"date-parts":[[2022,4]]},"abstract":"<jats:sec>\n            <jats:title>Objectives<\/jats:title>\n            <jats:p>This review aimed to explore and summarize information from available cases of pediatric acute hydroxychloroquine overdose with confirmed hydroxychloroquine exposure to give the clinicians a helpful perspective for its better recognition and management.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>Electronic searches were conducted in PubMed\/MEDLINE, Web of Science, Scopus, EBSCO and Serbian Citation Index. The abstracts from 2 toxicology conferences were manually checked for additional relevant publications, as well as reference lists of the retrieved publications. Descriptive statistics, narrative summation, and tabulation of the extracted data were made.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Nine publications and a total of 9 patients were included in the review. Reported age of the patients varied from 2.5 to 16 years (median, 16 years). There were more female patients (77.8%). Estimated total ingested hydroxychloroquine dose was reported in 7 cases (77.8%), and it ranged from 4.0 to 20.0 g (median: 12.0 g). Four patients (44.4%) ingested hydroxychloroquine with a coingestant. Altered mental status (100.0%), cardiotoxicity (88.9%), hypotension (77.8%), and hypokalemia (55.6%) were the most commonly reported clinical manifestations. The majority of the patients were hospitalized (88.9%). More than half of the patients (55.6%) were reported to be treated in the intensive care unit. Most frequently reported therapeutic measures were the following: administration of intravenous fluids\/infusions (77.8%), vasopressors (77.8%), bicarbonate therapy\u2014sodium bicarbonate (66.7%), potassium replacement (55.6%), and intubation\/ventilation (55.6%). Three patients (33.3%) died.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>Management of acute hydroxychloroquine overdose in children should be symptomatic and tailored to observed clinical manifestations. There is a need for additional investigations to better understand the impact and effectiveness of various treatment options.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/pec.0000000000002547","type":"journal-article","created":{"date-parts":[[2021,9,27]],"date-time":"2021-09-27T19:42:21Z","timestamp":1632771741000},"page":"174-182","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Acute Hydroxychloroquine Overdose"],"prefix":"10.1097","volume":"38","author":[{"given":"Ana V.","family":"Pej\u010di\u0107","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","published-online":{"date-parts":[[2021,9,22]]},"reference":[{"key":"bib2-20250504","first-page":"760","article-title":"Brief review of chloroquine and hydroxychloroquine toxicity and management","volume":"21","year":"2020","journal-title":"West J Emerg Med"},{"key":"bib3-20250504","doi-asserted-by":"crossref","first-page":"bcr2016218786","DOI":"10.1136\/bcr-2016-218786","article-title":"Accidental hydroxychloroquine overdose resulting in neurotoxic vestibulopathy","volume":"2017","year":"2017","journal-title":"BMJ Case Rep"},{"key":"bib4-20250504","doi-asserted-by":"crossref","first-page":"314","DOI":"10.1007\/s13181-020-00790-8","article-title":"Intentional hydroxychloroquine overdose treated with high-dose diazepam: an increasing concern in the COVID-19 pandemic","volume":"16","year":"2020","journal-title":"J Med Toxicol"},{"key":"bib6-20250504","doi-asserted-by":"crossref","first-page":"2461","DOI":"10.1007\/s10067-020-05202-4","article-title":"Hydroxychloroquine and chloroquine in COVID-19: should they be used as standard therapy?","volume":"39","year":"2020","journal-title":"Clin Rheumatol"},{"key":"bib7-20250504","doi-asserted-by":"crossref","first-page":"284","DOI":"10.1007\/s13181-020-00777-5","article-title":"COVID-19: therapeutics and their toxicities","volume":"16","year":"2020","journal-title":"J Med Toxicol"},{"key":"bib8-20250504","first-page":"210","article-title":"Acute hydroxychloroquine (Plaquenil\u00ae) ingestion by young children","volume":"37","year":"2009","journal-title":"J Emerg Med"},{"key":"bib9-20250504","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1007\/s40261-018-0726-1","article-title":"Drugs that can kill a toddler with one tablet or teaspoonful: a 2018 updated list","volume":"39","year":"2019","journal-title":"Clin Drug Investig"},{"key":"bib10-20250504","doi-asserted-by":"crossref","first-page":"1040","DOI":"10.1016\/j.toxrep.2019.10.006","article-title":"Diagnostic pitfalls and laboratory test interference after hydroxychloroquine intoxication: a case report","volume":"6","year":"2019","journal-title":"Toxicol Rep"},{"key":"bib11-20250504","doi-asserted-by":"crossref","first-page":"2209","DOI":"10.1016\/j.ajem.2020.07.030","article-title":"Acute chloroquine and hydroxychloroquine toxicity: a review for emergency clinicians","volume":"38","year":"2020","journal-title":"Am J Emerg Med"},{"key":"bib12-20250504","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1080\/15563650.2020.1817479","article-title":"Toxicity of chloroquine and hydroxychloroquine following therapeutic use or overdose","volume":"59","year":"2021","journal-title":"Clin Toxicol"},{"key":"bib13-20250504","doi-asserted-by":"crossref","first-page":"437","DOI":"10.1016\/j.jemermed.2004.12.011","article-title":"Are 1\u20132 dangerous? 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