Pediatr Emerg Med J.  2023 Jan;10(1):41-44. 10.22470/pemj.2022.00584.

A case of methamphetamine intoxication in an adolescent

• Kim JH
• Jung JY
• Park JW
• Lee EJ
• Lee HN
• Jue JH

• KMID: 2538082
• DOI: http://doi.org/10.22470/pemj.2022.00584

Abstract

With the age of exposure to illegal substances decreasing and abuse of drugs such as methamphetamine increasing, substance abuse is no longer limited to adults. We report a Korean case of a 17-year-old girl with acute methamphetamine poisoning. The girl visited the emergency department for vomiting and loss of consciousness, with needle marks found on both arms. QT prolongation was confirmed on the initial electrocardiogram, so that we suspected drug addiction and proceeded with toxicologic tests. A lethal dose of methamphetamine was confirmed. We discontinued QT prolonging drugs, and closely monitored the girl in the pediatric emergency intensive care unit until the QT prolongation was resolved. This case highlights the recognition of pediatric methamphetamine poisoning in emergency departments.

Keyword

Adolescent; Electrocardiogram QT Prolonged; Methamphetamine; Poisoning; Substance-Related Disorders

Figure

• 

  Fig. 1. The changes in QTc interval on the electrocardiograms. It was 604 ms at the time of the visit (A) and 641 ms 6 hours after the visit (B).

Reference

References

1. MacKenzie RG, Heischober B. Methamphetamine. Pediatr Rev. 1997; 18:305–9.

2. Kevil CG, Goeders NE, Woolard MD, Bhuiyan MS, Dominic P, Kolluru GK, et al. Methamphetamine use and cardiovascular disease. Arterioscler Thromb Vasc Biol. 2019; 39:1739–46.

3. Malashock HR, Yeung C, Roberts AR, Snow JW, Gerkin RD, O’Connor AD. Pediatric Methamphetamine toxicity: clinical manifestations and therapeutic use of antipsychotics-one institution’s experience. J Med Toxicol. 2021; 17:168–75.

4. Yigit M, Gokdol MY, Kalaycı F, Akca Caglar A, Akcan Yıldız L, Kurt F, et al. Methamphetamine intoxication in children: a single-center experience. Turkish J Pediatr Dis. 2022; Jun. 1. [Epub]. https://doi.org/10.12956/tchd.1085284.

5. Logan BK, Fligner CL, Haddix T. Cause and manner of death in fatalities involving methamphetamine. J Forensic Sci. 1998; 43:28–34.

6. Druid H, Holmgren P. A compilation of fatal and control concentrations of drugs in postmortem femoral blood. J Forensic Sci. 1997; 42:79–87.

7. Martínez-Aguirre AE, Romero-Mejía C, Chacón-Cruz E. Perforated peptic ulcer: is the form of methamphetamine known as “crystal meth” a new risk factor? Rev Gastroenterol Mex. 2012; 77:108–13.

8. Ok YB, Kim JY, Lee KR, Hong DY, Baek KJ, Park SO, et al. A clinical review of patients who visited emergency medical center with positive methamphetamine tests: a single institute study. J Korean Soc Clin Toxicol. 2018; 16:25–32. Korean.

9. Lee SK, Choi S. Availability of urine toxicologic screening tests in the emergency department: focused on illegal drugs. J Korean Soc Clin Toxicol. 2021; 19:24–30. Korean.