Evidence map›Paper›PMID 32918170›Full record

ArticleCardiovascular toxicology2021

Massive β1-Adrenergic Receptor Reaction Explains Irreversible Acute Arrhythmia in a Fatal Case of Acute Pure Caffeine Intoxication.

Aniello Maiese, Raffaele La Russa, Zoe Del Fante, Emanuela Turillazzi, Maria Chiara David, Paola Frati, Vittorio Fineschi

Abstract readCase Reports
PubMed Publisher
In one paragraph

Article in Cardiovascular toxicology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
0.3field-weighted citation impact, top 38% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 4 citations in OpenAlex.

  1. Review
  2. Article
  3. Review
  4. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 4 institutions in 1 country.

Aniello MaieseInstitute of Legal Medicine, Department of Surgical Pathology, Medical, Molecular and Critical Area, University of Pisa, Ospedale Santa Chiara, Via Roma 55, 56126, Pisa, Italy.
Raffaele La RussaDepartment of Anatomical, Histological, Forensic and Orthopaedic Sciences, Sapienza University of Rome, Viale Regina Elena 336, 00185, Rome, Italy.
Zoe Del FanteDepartment of Anatomical, Histological, Forensic and Orthopaedic Sciences, Sapienza University of Rome, Viale Regina Elena 336, 00185, Rome, Italy.
Emanuela TurillazziInstitute of Legal Medicine, Department of Surgical Pathology, Medical, Molecular and Critical Area, University of Pisa, Ospedale Santa Chiara, Via Roma 55, 56126, Pisa, Italy.
Maria Chiara DavidForensic Science Department of Biomedicine and Prevention, Tor Vergata University of Rome, Rome, Italy.
Paola FratiDepartment of Anatomical, Histological, Forensic and Orthopaedic Sciences, Sapienza University of Rome, Viale Regina Elena 336, 00185, Rome, Italy.
Vittorio FineschiDepartment of Anatomical, Histological, Forensic and Orthopaedic Sciences, Sapienza University of Rome, Viale Regina Elena 336, 00185, Rome, Italy. vfinesc@tin.it.ORCID 0000-0002-1686-3236
Istituto Neurologico Mediterraneo · ITSapienza University of Rome · ITUniversity of Pisa · ITUniversity of Rome Tor Vergata · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Caffeine, a naturally occurring purine-based alkaloid, is the most consumed psychostimulant worldwide. Since caffeine pharmacokinetics shows extreme interindividual variability, it is not easy to establish its toxic dose. Only a few cases of death due to acute caffeine intoxication have been described so far, the majority of which attributable to massive assumption of caffeine-based medications. We present a case of acute caffeine overdose due to ingestion of pure caffeine. The extremely high blood concentration of caffeine determined a strong cardiovascular response, leading to fatal arrhythmia, as supported by histological evidence of myocardial injury. Quantitation of catecholamines and their metabolites in urine samples was performed and showed level near the highest limit of normal ranges for norepinephrine and high level of epinephrine. Contraction band is a pathological modification of the myocell caused by the catecholaminergic action and can occur in conditions of alteration due to the interaction between calcium and catecholamines. We demonstrated the β1-adrenoceptor involvement in our fatal case by immunohistochemical analysis.

Indexed as

AdultArrhythmias, CardiacCaffeineCentral Nervous System StimulantsEpinephrineFatal OutcomeFemaleHeart RateHumansNorepinephrineReceptors, Adrenergic, beta-1ADRB1 protein, humanCaffeineCentral Nervous System StimulantsEpinephrineNorepinephrineReceptors, Adrenergic, beta-1Acute intoxicationAdrenergic stressArrhythmiaArrhythmogenic supersensitivityCaffeineΒ1 adrenergic receptor

Identifiers

PMID32918170
OpenAlexW3085562276

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.