Evidence map›Paper›PMID 38851740›Full record

ArticleJournal of medical case reports2024

Not only Van Gogh: a case of BRASH syndrome with concomitant digoxin toxicity.

Ilaria Costantini, Giovanni Mantelli, Massimo Carollo, Lorenzo Losso, Elia Morando, Matilde Bacchion, Mariapaola Castri, Lucia Drezza, Giorgio Ricci

Abstract readCase Reports
In one paragraph

Article in Journal of medical case reports, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
–field-weighted citation impact
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

1 citing paper in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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

9 authors.

Ilaria Costantini *USD Poison Control Center, Azienda Ospedaliera Universitaria Integrata, Verona, Italy.
Giovanni Mantelli *USD Poison Control Center, Azienda Ospedaliera Universitaria Integrata, Verona, Italy.
Massimo CarolloClinical Pharmacology Unit, Department of Diagnostics and Public Health, University of Verona, Verona, Italy. massimo.carollo@univr.it.ORCID http://orcid.org/0000-0002-6523-6036
Lorenzo LossoUSD Poison Control Center, Azienda Ospedaliera Universitaria Integrata, Verona, Italy.
Elia MorandoUSD Poison Control Center, Azienda Ospedaliera Universitaria Integrata, Verona, Italy.
Matilde BacchionUSD Poison Control Center, Azienda Ospedaliera Universitaria Integrata, Verona, Italy.
Mariapaola CastriDepartment of Medicine, University of Verona, Verona, Italy.
Lucia DrezzaUSD Poison Control Center, Azienda Ospedaliera Universitaria Integrata, Verona, Italy.
Giorgio RicciUSD Poison Control Center, Azienda Ospedaliera Universitaria Integrata, Verona, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundBradycardia, renal failure, atrioventricular (AV) node blocking, shock, and hyperkalemia syndrome is a potentially life-threatening clinical condition characterized by bradycardia, renal failure, atrioventricular (AV) node blocking, shock, and hyperkalemia. It constitutes a vicious circle in which the accumulation of pharmacologically active compounds and hyperkalemia lead to hemodynamic instability and heart failure. CASE PRESENTATION: A 66-year-old Caucasian female patient was admitted to the emergency department presenting with fatigue and bradycardia. Upon examination, the patient was found to be anuric and hypotensive. Laboratory investigations revealed metabolic acidosis and hyperkalemia. Clinical evaluation suggested signs of digoxin toxicity, with serum digoxin concentrations persistently elevated over several days. Despite the implementation of antikalemic measures, the patient's condition remained refractory, necessitating renal dialysis and administration of digoxin immune fab.

conclusionBradycardia, renal failure, atrioventricular (AV) node blocking, shock, and hyperkalemia syndrome is a life-threatening condition that requires prompt management. It is important to also consider potential coexisting clinical manifestations indicative of intoxication from other pharmacological agents. Specifically, symptoms associated with the accumulation of drugs eliminated via the kidneys, such as digoxin. These manifestations may warrant targeted therapeutic measures.

Indexed as

BradycardiaDigoxinHyperkalemiaRenal DialysisAcidosisAgedAnti-Arrhythmia AgentsAtrioventricular BlockFemaleHumansImmunoglobulin Fab FragmentsRenal InsufficiencyShockSyndromeAnti-Arrhythmia AgentsDigoxindigoxin antibodies Fab fragmentsImmunoglobulin Fab FragmentsBradycardiaBRASH syndromeCase reportDigoxin toxicityHyperkalemia

Identifiers

PMID38851740
PMCPMC11162566

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Registered trials

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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.