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LETTER TO EDITOR
Year : 2020  |  Volume : 7  |  Issue : 5  |  Page : 297

Carbamazepine poisoning: A narrow escape


Department of Paediatrics, Al-Kindy College of Medicine, University of Baghdad, Baghdad, Iraq

Date of Submission31-May-2020
Date of Acceptance21-Jun-2020
Date of Web Publication14-Sep-2020

Correspondence Address:
Prof. Mahmood Dhahir Al-Mendalawi
P. O. Box 55302, Baghdad Post Office, Baghdad
Iraq
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/JPCC.JPCC_93_20

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How to cite this article:
Al-Mendalawi MD. Carbamazepine poisoning: A narrow escape. J Pediatr Crit Care 2020;7:297

How to cite this URL:
Al-Mendalawi MD. Carbamazepine poisoning: A narrow escape. J Pediatr Crit Care [serial online] 2020 [cited 2020 Dec 2];7:297. Available from: http://www.jpcc.org.in/text.asp?2020/7/5/297/295029



In May–June 2020 issue of the Journal of Pediatric Critical Care, Kaiser et al.[1] reported a case of carbamazepine poisoning in a 1-year and 6-month-old Indian child. I have two comments on it.

First, though there was a history of ingestion of three tablets of carbamazepine (200 mg each), I wonder why Kaiser et al.[1] did not attempt to measure blood level of carbamazepine in their studied child at the initial presentation and serially. Actually, such measurement is pivotal to confirm diagnosis of poisoning with carbamazepine, plan certain therapeutic measures based on the carbamazepine level in blood, and help predict the outcome.[2]

Second, I do agree with Kaiser et al.,[1] in their statement that “the case is unique in its own way because of the extremely critical state in which this child presented and also the unfavorable neurodevelopmental outcome.”[1] Another unique aspect in the case in question is that the poisoning occurred in a young child. Despite most of poisoning incidents in young children are due to their curiosity and exploration of the surroundings by mouth which could be importantly prevented by the close family supervision, poisoning in young children and infants could be one form of child abuse.[3] Interestingly, it has been reported that 6% of poisoning victims under the age of 6 years referred to the child protective services were due to concerns for intentional poisoning.[4] Although the poisoned child reported by Kaiser et al.[1] survived with neurodevelopmental sequelae, intentional poisoning with the carbamazepine induced by parents ought not to be overlooked. Hence, psychological evaluation of parents must be taken into consideration.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Kaiser RS, Dutta A, Sarkar M, Datta K. Carbamazepine poisoning: A narrow escape. J Pediatr Crit Care 2020;7:136-9.  Back to cited text no. 1
  [Full text]  
2.
Spiller HA. Management of carbamazepine overdose. Pediatr Emerg Care 2001;17:452-6.  Back to cited text no. 2
    
3.
Dinis-Oliveira RJ, Magalhães T. Children intoxications: What is abuse and what is not abuse. Trauma Violence Abuse 2013;14:113-32.  Back to cited text no. 3
    
4.
Wood JN, Pecker LH, Russo ME, Henretig F, Christian CW. Evaluation and referral for child maltreatment in pediatric poisoning victims. Child Abuse Negl 2012;36:362-9.  Back to cited text no. 4
    




 

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