{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,9]],"date-time":"2026-11-09T21:05:09Z","timestamp":1794258309913,"version":"4.9.0"},"reference-count":22,"publisher":"Japanese Society of Internal Medicine","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Intern. Med."],"published-print":{"date-parts":[[2026]]},"DOI":"10.2169\/internalmedicine.7976-26","type":"journal-article","created":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T22:11:34Z","timestamp":1792620694000},"source":"Crossref","is-referenced-by-count":1,"title":["A Diphenhydramine Overdose Mimicking Encephalitis, Complicated by Acute Kidney Injury Associated with Anticholinergic Urinary Retention: A Case Report"],"prefix":"10.2169","author":[{"given":"Hiroyasu","family":"Inoue","sequence":"first","affiliation":[{"name":"Department of Neurology, Nagoya City University Graduate School of Medical Sciences, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erina","family":"Miwa","sequence":"additional","affiliation":[{"name":"Department of Neurology, Nagoya City University Graduate School of Medical Sciences, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuta","family":"Madokoro","sequence":"additional","affiliation":[{"name":"Department of Neurology, Nagoya City University Graduate School of Medical Sciences, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takahisa","family":"Kasugai","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Nagoya City University Graduate School of Medical Sciences, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shumpei","family":"Madokoro","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuto","family":"Uchida","sequence":"additional","affiliation":[{"name":"Department of Neurology, Nagoya City University Graduate School of Medical Sciences, Japan"},{"name":"Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shoji","family":"Kawashima","sequence":"additional","affiliation":[{"name":"Department of Neurology, Nagoya City University Graduate School of Medical Sciences, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masahiro","family":"Oomura","sequence":"additional","affiliation":[{"name":"Department of Neurology, Nagoya City University Graduate School of Medical Sciences, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noriyuki","family":"Matsukawa","sequence":"additional","affiliation":[{"name":"Department of Neurology, Nagoya City University Graduate School of Medical Sciences, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"962","reference":[{"key":"1","doi-asserted-by":"crossref","unstructured":"1. Filloux F. Toxic encephalopathy caused by topically applied diphenhydramine. J Pediatr 108: 1018-1020, 1986.","DOI":"10.1016\/S0022-3476(86)80953-2"},{"key":"2","doi-asserted-by":"crossref","unstructured":"2. Reilly JF, Weisse ME. Topically induced diphenhydramine toxicity. J Emerg Med 8: 59-61, 1990.","DOI":"10.1016\/0736-4679(90)90389-D"},{"key":"3","doi-asserted-by":"crossref","unstructured":"3. Tomlinson G, Helfaer M, Wiedermann BL. Diphenhydramine toxicity mimicking varicella encephalitis. Pediatr Infect Dis J 6: 220-221, 1987.","DOI":"10.1097\/00006454-198702000-00020"},{"key":"4","doi-asserted-by":"crossref","unstructured":"4. Chan CY, Wallander KA. Diphenhydramine toxicity in three children with varicella-zoster infection. DICP 25: 130-132, 1991.","DOI":"10.1177\/106002809102500204"},{"key":"5","doi-asserted-by":"crossref","unstructured":"5. Radovanovic D, Meier PJ, Guirguis M, Lorent JP, Kupferschmidt H. Dose-dependent toxicity of diphenhydramine overdose. Hum Exp Toxicol 19: 489-495, 2000.","DOI":"10.1191\/096032700671040438"},{"key":"6","doi-asserted-by":"crossref","unstructured":"6. Ito R, Kobayashi S, Terashima H, et al. False-positive tricyclic antidepressant results in diphenhydramine overdose: a report of two cases and a literature review. BMC Neurol 26: 73, 2026.","DOI":"10.1186\/s12883-025-04620-8"},{"key":"7","unstructured":"7. Venkatesan A, Tunkel AR, Bloch KC, et al. Case definitions, diagnostic algorithms, and priorities in encephalitis: consensus statement of the International Encephalitis Consortium. Clin Infect Dis 57: 1114-1128, 2013."},{"key":"8","doi-asserted-by":"crossref","unstructured":"8. Ellul M, Solomon T. Acute encephalitis - diagnosis and management. Clin Med (Lond) 18: 155-159, 2018.","DOI":"10.7861\/clinmedicine.18-2-155"},{"key":"9","unstructured":"9. Takenaka N, Hirakawa A, Kano H, Tsuda M, Takeyama N, Hattori T. A acute intoxication by overdose of Travelmin<sup>\u24c7<\/sup> beyond the lethal dose, combination drug of diphenhydramine with diprophylline. Nihon Rinsho Kyukyu Igakkai Zasshi (Journal of Japanese Society for Emergency Medicine) 20: 672-677, 2017 (in Japanese)."},{"key":"10","unstructured":"10. McGann KP, Pribanich S, Graham JA, Browning DG. Diphenhydramine toxicity in a child with varicella. a case report. J Fam Pract 35: 210-214, 1992."},{"key":"11","doi-asserted-by":"crossref","unstructured":"11. Frank MA, Lund J, Langley DM, Annis M, Peredy TR. Diphenhydramine overdose: a case report and topic review of prehospital diagnosis and treatment. Cureus 16: e70719, 2024.","DOI":"10.7759\/cureus.70719"},{"key":"12","doi-asserted-by":"crossref","unstructured":"12. Scharman EJ, Erdman AR, Wax PM, et al. Diphenhydramine and dimenhydrinate poisoning: an evidence-based consensus guideline for out-of-hospital management. Clin Toxicol (Phila) 44: 205-223, 2006.","DOI":"10.1080\/15563650600585920"},{"key":"13","doi-asserted-by":"crossref","unstructured":"13. Irioka T, Yamanami A, Uchida N, Iwase M, Yasuhara H, Mizusawa H. Opsoclonus caused by diphenhydramine self-poisoning. J Neuroophthalmol 29: 72-73, 2009.","DOI":"10.1097\/WNO.0b013e318197f6ff"},{"key":"14","doi-asserted-by":"crossref","unstructured":"14. Carstairs SD, Schneir AB. Opsoclonus due to diphenhydramine poisoning. N Engl J Med 363: e40, 2010.","DOI":"10.1056\/NEJMicm1002035"},{"key":"15","doi-asserted-by":"crossref","unstructured":"15. Lee SJ, Shin IJ, Kim TJ. Opsoclonus myoclonus ataxia may differentiate postinfectious autoimmune encephalitis from infectious encephalitis. Neurol Sci 42: 5395-5398, 2021.","DOI":"10.1007\/s10072-021-05632-1"},{"key":"16","doi-asserted-by":"crossref","unstructured":"16. Wong A. An update on opsoclonus. Curr Opin Neurol 20: 25-31, 2007.","DOI":"10.1097\/WCO.0b013e3280126b51"},{"key":"17","doi-asserted-by":"crossref","unstructured":"17. Perazella MA. Crystal-induced acute renal failure. Am J Med 106: 459-465, 1999.","DOI":"10.1016\/S0002-9343(99)00041-8"},{"key":"18","doi-asserted-by":"crossref","unstructured":"18. Fleischer R, Johnson M. Acyclovir nephrotoxicity: a case report highlighting the importance of prevention, detection, and treatment of acyclovir-induced nephropathy. Case Rep Med 2010: 602783, 2010.","DOI":"10.1155\/2010\/602783"},{"key":"19","doi-asserted-by":"crossref","unstructured":"19. Yaxley J, Yaxley W. Obstructive uropathy - acute and chronic medical management. World J Nephrol 12: 1-9, 2023.","DOI":"10.5527\/wjn.v12.i1.1"},{"key":"20","doi-asserted-by":"crossref","unstructured":"20. Verhamme KM, Sturkenboom MC, Stricker BH, Bosch R. Drug-induced urinary retention. Drug Saf 31: 373-388, 2008.","DOI":"10.2165\/00002018-200831050-00002"},{"key":"21","doi-asserted-by":"crossref","unstructured":"21. Haas CE, Magram Y, Mishra A. Rhabdomyolysis and acute renal failure following an ethanol and diphenhydramine overdose. Ann Pharmacother 37: 538-542, 2003.","DOI":"10.1345\/aph.1C241"},{"key":"22","unstructured":"22. Kawahara J, Morita T, Yokoyama M. A case of diphenhydramine intoxication positive for a tricyclic antidepressant and methadone in a simple urine toxicology test. Nihon Byoin Sogo Shinryo Igakkai Zasshi (Web) 21: 33-38, 2025 (in Japanese)."}],"container-title":["Internal Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.jstage.jst.go.jp\/article\/internalmedicine\/advpub\/0\/advpub_7976-26\/_pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T04:13:13Z","timestamp":1792815193000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.jstage.jst.go.jp\/article\/internalmedicine\/advpub\/0\/advpub_7976-26\/_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026]]},"references-count":22,"URL":"https:\/\/doi.org\/10.2169\/internalmedicine.7976-26","relation":{},"ISSN":["0918-2918","1349-7235"],"issn-type":[{"value":"0918-2918","type":"print"},{"value":"1349-7235","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026]]},"article-number":"7976-26"}}