{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T16:45:15Z","timestamp":1791909915510,"version":"4.3.4"},"reference-count":7,"publisher":"BMJ","issue":"6","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2020,5,16]]},"published-print":{"date-parts":[[2020,6]]},"abstract":"<jats:p>We present a man undergoing regular haemodialysis sessions, who presented with non-specific symptoms of nausea, vomiting and light-headedness. He was found to have significantly raised serum digoxin concentrations, as well as a heart rate of 30 beats per minutes. An ECG showed complete heart block. He has a history of non-ischaemic dilated cardiomyopathy with resistant supraventricular and ventricular tachycardias and was on concomitant beta-blockade and digoxin. On questioning, he reported a gradual decline in his residual urine output over the past 6\u2009months. He was reviewed by the cardiology team and required both pharmacological therapy for reversal of digoxin toxicity and temporary pacing in view of significant bradyarrhythmias. The beta-blockade and digoxin were discontinued. He was kept on continuous monitoring at the Cardiac Critical Care Unit. His symptoms resolved spontaneously once digoxin-specific antibody fragments were administered and temporary pacing successfully performed.<\/jats:p>","DOI":"10.1136\/bcr-2020-234899","type":"journal-article","created":{"date-parts":[[2020,6,17]],"date-time":"2020-06-17T02:55:14Z","timestamp":1592362514000},"page":"e234899","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Symptomatic digoxin toxicity in a patient on haemodialysis"],"prefix":"10.1136","volume":"13","author":[{"given":"Lara","family":"Delicata","sequence":"first","affiliation":[{"name":"Department of Nephrology, Mater Dei Hospital, Msida, Malta"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arl\u00e8ne","family":"Gatt","sequence":"additional","affiliation":[{"name":"Department of Medicine, Mater Dei Hospital, Msida, Malta"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Luc","family":"Paris","sequence":"additional","affiliation":[{"name":"Department of Medicine, Mater Dei Hospital, Msida, Malta"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Bonello","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Mater Dei Hospital, Msida, Malta"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2020,6,16]]},"reference":[{"key":"2025082712342841000_13.6.e234899.1","doi-asserted-by":"publisher","DOI":"10.1097\/01.ASN.0000135121.81744.75"},{"key":"2025082712342841000_13.6.e234899.2","first-page":"223","article-title":"Digoxin toxicity: case for retiring its use in elderly patients?","volume":"62","author":"MacLeod-Glover","year":"2016","journal-title":"Can Fam Physician"},{"key":"2025082712342841000_13.6.e234899.3","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2009101047"},{"key":"2025082712342841000_13.6.e234899.4","doi-asserted-by":"crossref","first-page":"18","DOI":"10.18773\/austprescr.2016.006","article-title":"Management of digoxin toxicity","volume":"39","author":"Pincus","year":"2016","journal-title":"Aust Prescr"},{"key":"2025082712342841000_13.6.e234899.5","doi-asserted-by":"crossref","first-page":"510","DOI":"10.1097\/00007691-199710000-00004","article-title":"Digoxin intoxication in a patient with end-stage renal disease","volume":"19","author":"Capsi","year":"1997","journal-title":"Therapeutic Drug Monitoring"},{"key":"2025082712342841000_13.6.e234899.6","doi-asserted-by":"crossref","first-page":"103","DOI":"10.3109\/15563650.2015.1118488","article-title":"Extracorporeal treatment for digoxin poisoning: systematic review and recommendations from the EXTRIP Workgroup","volume":"54","author":"Mowry","year":"2016","journal-title":"Clin Toxicol"},{"key":"2025082712342841000_13.6.e234899.7","doi-asserted-by":"crossref","first-page":"798.e3","DOI":"10.1016\/j.ajem.2019.01.038","article-title":"Digoxin-Specific Fab and therapeutic plasma exchange for digitalis intoxication and renal failure","volume":"37","author":"Pellegrino","year":"2019","journal-title":"Am J Emerg Med"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2020-234899","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T19:34:35Z","timestamp":1756323275000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2020-234899"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,6]]},"references-count":7,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2020,6,16]]},"published-print":{"date-parts":[[2020,6]]}},"alternative-id":["10.1136\/bcr-2020-234899"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2020-234899","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,6]]}}}