Brugada Syndrome Associated With Adolescent Loperamide Abuse
We present the case of a 14-year-old boy with obesity, hypertension, and chronic loperamide abuse who presented to our facility with symptoms of opioid withdrawal and type 1 Brugada pattern on an electrocardiogram. He was treated for anxiety and withdrawal. There were no documented dysrhythmias. His...
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| Veröffentlicht in: | Pediatrics (Evanston) 2018-10, Vol.142 (4), p.e20181423 |
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| creator | Stefek, Bryan Wolfe, L Timothy Cohen, Mark |
| description | We present the case of a 14-year-old boy with obesity, hypertension, and chronic loperamide abuse who presented to our facility with symptoms of opioid withdrawal and type 1 Brugada pattern on an electrocardiogram. He was treated for anxiety and withdrawal. There were no documented dysrhythmias. His Brugada pattern resolved by hospital day 5 and remained resolved 12 days postadmission. Genetic testing revealed a heterozygous missense mutation in the SCN5A gene (c. 5038G>A, p. Ala1680Thr), which has been reported in association with Brugada syndrome. To date, there are no published reports of pediatric loperamide use associated with a Brugada pattern on an electrocardiogram. We propose that chronic loperamide use unmasked the electrocardiographic phenotype associated with his gene mutation. |
| doi_str_mv | 10.1542/peds.2018-1423 |
| format | Article |
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He was treated for anxiety and withdrawal. There were no documented dysrhythmias. His Brugada pattern resolved by hospital day 5 and remained resolved 12 days postadmission. Genetic testing revealed a heterozygous missense mutation in the SCN5A gene (c. 5038G>A, p. Ala1680Thr), which has been reported in association with Brugada syndrome. To date, there are no published reports of pediatric loperamide use associated with a Brugada pattern on an electrocardiogram. We propose that chronic loperamide use unmasked the electrocardiographic phenotype associated with his gene mutation.</description><identifier>ISSN: 0031-4005</identifier><identifier>EISSN: 1098-4275</identifier><identifier>DOI: 10.1542/peds.2018-1423</identifier><identifier>PMID: 30254039</identifier><language>eng</language><publisher>United States: American Academy of Pediatrics</publisher><subject>Abuse ; Adolescent ; Analgesics, Opioid - adverse effects ; Antidiarrheals - adverse effects ; Anxiety ; Brugada Syndrome - chemically induced ; Brugada Syndrome - diagnosis ; Brugada Syndrome - genetics ; Complications and side effects ; Dosage and administration ; Drug abuse ; Drug use ; EKG ; Electrocardiogram ; Electrocardiography ; Gene mutation ; Gene mutations ; Genetic screening ; Health aspects ; Humans ; Loperamide ; Loperamide - adverse effects ; Male ; Missense mutation ; Mutation ; Mutation, Missense - genetics ; Narcotics ; Obesity ; Obesity - diagnosis ; Obesity - drug therapy ; Obesity - physiopathology ; Opioids ; Pediatrics ; Phenotypes ; Point mutation ; Substance-Related Disorders - diagnosis ; Substance-Related Disorders - genetics ; Teenagers ; Youth</subject><ispartof>Pediatrics (Evanston), 2018-10, Vol.142 (4), p.e20181423</ispartof><rights>Copyright © 2018 by the American Academy of Pediatrics.</rights><rights>Copyright American Academy of Pediatrics Oct 2018</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c331t-df88cfbc3574295594625cc4421cdf42ed166dc0b2c161ec50bbca1a9280d103</citedby><cites>FETCH-LOGICAL-c331t-df88cfbc3574295594625cc4421cdf42ed166dc0b2c161ec50bbca1a9280d103</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30254039$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Stefek, Bryan</creatorcontrib><creatorcontrib>Wolfe, L Timothy</creatorcontrib><creatorcontrib>Cohen, Mark</creatorcontrib><title>Brugada Syndrome Associated With Adolescent Loperamide Abuse</title><title>Pediatrics (Evanston)</title><addtitle>Pediatrics</addtitle><description>We present the case of a 14-year-old boy with obesity, hypertension, and chronic loperamide abuse who presented to our facility with symptoms of opioid withdrawal and type 1 Brugada pattern on an electrocardiogram. He was treated for anxiety and withdrawal. There were no documented dysrhythmias. His Brugada pattern resolved by hospital day 5 and remained resolved 12 days postadmission. Genetic testing revealed a heterozygous missense mutation in the SCN5A gene (c. 5038G>A, p. Ala1680Thr), which has been reported in association with Brugada syndrome. To date, there are no published reports of pediatric loperamide use associated with a Brugada pattern on an electrocardiogram. We propose that chronic loperamide use unmasked the electrocardiographic phenotype associated with his gene mutation.</description><subject>Abuse</subject><subject>Adolescent</subject><subject>Analgesics, Opioid - adverse effects</subject><subject>Antidiarrheals - adverse effects</subject><subject>Anxiety</subject><subject>Brugada Syndrome - chemically induced</subject><subject>Brugada Syndrome - diagnosis</subject><subject>Brugada Syndrome - genetics</subject><subject>Complications and side effects</subject><subject>Dosage and administration</subject><subject>Drug abuse</subject><subject>Drug use</subject><subject>EKG</subject><subject>Electrocardiogram</subject><subject>Electrocardiography</subject><subject>Gene mutation</subject><subject>Gene mutations</subject><subject>Genetic screening</subject><subject>Health aspects</subject><subject>Humans</subject><subject>Loperamide</subject><subject>Loperamide - adverse effects</subject><subject>Male</subject><subject>Missense mutation</subject><subject>Mutation</subject><subject>Mutation, Missense - genetics</subject><subject>Narcotics</subject><subject>Obesity</subject><subject>Obesity - diagnosis</subject><subject>Obesity - drug therapy</subject><subject>Obesity - physiopathology</subject><subject>Opioids</subject><subject>Pediatrics</subject><subject>Phenotypes</subject><subject>Point mutation</subject><subject>Substance-Related Disorders - diagnosis</subject><subject>Substance-Related Disorders - genetics</subject><subject>Teenagers</subject><subject>Youth</subject><issn>0031-4005</issn><issn>1098-4275</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkU1r20AQhpfS0LhJrz0GQS-5yJnZD1mCXhyTpgGDDzHkuKx2R46CpHV3JWj-fVY47SGnuTzz8s48jH1HWKKS_OZILi45YJmj5OITWyBUZS75Sn1mCwCBuQRQ5-xrjC8AINWKf2HnAriSIKoF-3kbpoNxJnt8HVzwPWXrGL1tzUgue2rH52ztfEfR0jBmW3-kYPrWJaqeIl2ys8Z0kb69zwu2_3W33_zOt7v7h816m1shcMxdU5a2qa1QK8krpSpZcGWtlBytayQnh0XhLNTcYoFkFdS1NWgqXoJDEBfs-hR7DP7PRHHUfZsKdZ0ZyE9Rc0ReIFcgE_rjA_ripzCkcolKV5fIJSYqP1EH05FuB-uHkf6O1ncdHUin7pudXqsCpZBVNacuT7wNPsZAjT6GtjfhVSPoWYOeNehZg541pIWr9xpT3ZP7j__7u3gDg-eAlA</recordid><startdate>201810</startdate><enddate>201810</enddate><creator>Stefek, Bryan</creator><creator>Wolfe, L Timothy</creator><creator>Cohen, Mark</creator><general>American Academy of Pediatrics</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TS</scope><scope>7U9</scope><scope>H94</scope><scope>K9.</scope><scope>M7N</scope><scope>NAPCQ</scope><scope>U9A</scope><scope>7X8</scope></search><sort><creationdate>201810</creationdate><title>Brugada Syndrome Associated With Adolescent Loperamide Abuse</title><author>Stefek, Bryan ; Wolfe, L Timothy ; Cohen, Mark</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c331t-df88cfbc3574295594625cc4421cdf42ed166dc0b2c161ec50bbca1a9280d103</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Abuse</topic><topic>Adolescent</topic><topic>Analgesics, Opioid - adverse effects</topic><topic>Antidiarrheals - adverse effects</topic><topic>Anxiety</topic><topic>Brugada Syndrome - chemically induced</topic><topic>Brugada Syndrome - diagnosis</topic><topic>Brugada Syndrome - genetics</topic><topic>Complications and side effects</topic><topic>Dosage and administration</topic><topic>Drug abuse</topic><topic>Drug use</topic><topic>EKG</topic><topic>Electrocardiogram</topic><topic>Electrocardiography</topic><topic>Gene mutation</topic><topic>Gene mutations</topic><topic>Genetic screening</topic><topic>Health aspects</topic><topic>Humans</topic><topic>Loperamide</topic><topic>Loperamide - adverse effects</topic><topic>Male</topic><topic>Missense mutation</topic><topic>Mutation</topic><topic>Mutation, Missense - genetics</topic><topic>Narcotics</topic><topic>Obesity</topic><topic>Obesity - diagnosis</topic><topic>Obesity - drug therapy</topic><topic>Obesity - physiopathology</topic><topic>Opioids</topic><topic>Pediatrics</topic><topic>Phenotypes</topic><topic>Point mutation</topic><topic>Substance-Related Disorders - diagnosis</topic><topic>Substance-Related Disorders - genetics</topic><topic>Teenagers</topic><topic>Youth</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Stefek, Bryan</creatorcontrib><creatorcontrib>Wolfe, L Timothy</creatorcontrib><creatorcontrib>Cohen, Mark</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Physical Education Index</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Pediatrics (Evanston)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Stefek, Bryan</au><au>Wolfe, L Timothy</au><au>Cohen, Mark</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Brugada Syndrome Associated With Adolescent Loperamide Abuse</atitle><jtitle>Pediatrics (Evanston)</jtitle><addtitle>Pediatrics</addtitle><date>2018-10</date><risdate>2018</risdate><volume>142</volume><issue>4</issue><spage>e20181423</spage><pages>e20181423-</pages><issn>0031-4005</issn><eissn>1098-4275</eissn><abstract>We present the case of a 14-year-old boy with obesity, hypertension, and chronic loperamide abuse who presented to our facility with symptoms of opioid withdrawal and type 1 Brugada pattern on an electrocardiogram. He was treated for anxiety and withdrawal. There were no documented dysrhythmias. His Brugada pattern resolved by hospital day 5 and remained resolved 12 days postadmission. Genetic testing revealed a heterozygous missense mutation in the SCN5A gene (c. 5038G>A, p. Ala1680Thr), which has been reported in association with Brugada syndrome. To date, there are no published reports of pediatric loperamide use associated with a Brugada pattern on an electrocardiogram. We propose that chronic loperamide use unmasked the electrocardiographic phenotype associated with his gene mutation.</abstract><cop>United States</cop><pub>American Academy of Pediatrics</pub><pmid>30254039</pmid><doi>10.1542/peds.2018-1423</doi><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Alma/SFX Local Collection |
| subjects | Abuse Adolescent Analgesics, Opioid - adverse effects Antidiarrheals - adverse effects Anxiety Brugada Syndrome - chemically induced Brugada Syndrome - diagnosis Brugada Syndrome - genetics Complications and side effects Dosage and administration Drug abuse Drug use EKG Electrocardiogram Electrocardiography Gene mutation Gene mutations Genetic screening Health aspects Humans Loperamide Loperamide - adverse effects Male Missense mutation Mutation Mutation, Missense - genetics Narcotics Obesity Obesity - diagnosis Obesity - drug therapy Obesity - physiopathology Opioids Pediatrics Phenotypes Point mutation Substance-Related Disorders - diagnosis Substance-Related Disorders - genetics Teenagers Youth |
| title | Brugada Syndrome Associated With Adolescent Loperamide Abuse |
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