ABSTRACTS POSTERS WETENSCHAPSDAG SFG 2012 to reduce alcohol craving and intake, and to promote alcohol abstinence [2]. Because baclofen is eliminated predominantly by the kidney, baclofen-related encephalopathy is usually found in patients with end-stage renal diseases or acute renal failure [3,4]. Therefore, hemodialysis has been suggested for those patients to alleviate symptoms and shorten recovery time. Recently, a case was reported to reveal that hemodialysis is beneficial to the baclofen-overdosed patient with normal renal function [5]. Here we present a case of baclofen intoxication with normal renal function with much higher serum concentrations of baclofen. CASE: A 42 year old woman with a history of nicotineabuse, multiple suicide attempts and alcoholabuse, presented at the emergency room after ingesting 120 tablets (25 mg) of baclofen together with 10 cans of beer (500 ml). She did not receive gastric lavage and activated charcoal administration. The patient was intubated because of deep coma (Glasgow Coma Scale score: 3) and respiratory depression. Her blood pressure was 119/57 mm Hg; heart rate: 62 beats per minute and body temperature: 35.8°C. Neurologic examination at admission revealed no localizing signs. Whitin an hour we observed myoclonus and seizures. The EKG was normal at first; later she developed a bradycardia. The laboratory data showed normal liver function. The lactate levels were within normal limits. The alchol-promillage was 65 mmol/l. The patient received emergent hemodialysis. After one session of hemodialysis, the serum baclofen concentration was still high and a second session was needed. Some side effects as hypotension, bradycardias and convulsions were present in our patient. Her consciousness returned after the completion of the second hemodialysis treatment. Blood samples for serum baclofen measurement were collected immediately after arrival and at 5 (end of first hemodialysis), 6 (end of second hemodialysis), 12 and 36 hours. The therapeutic range of baclofen is 80-400 ng/ml in normal subjects [6]. Serum baclofen concentration at arrival was 13.3 mg/L (13.300 ng/ml). The serum concentration of baclofen was decreased by 19.5% after the first hemodialyse and 70.7% after the second. Symptoms like convulsions, myoclonus and bradycardias were gone after the dialysis sessions. The patient was extubated not until day 4 and was discharged soon after. CONCLUSION: In conclusion: patients with baclofen overdose could show a prolonged elimination time even with normal renal function. Thus: hemodialysis would be beneficial to those patients with normal renal function. Franciscus Rheumatoid Arthritis aNd Cardiovascular Intervention Study – opzet en rationale. D.F. van Breukelen-van der Stoep1 huisman1 Cabezas2 , G.J.M van de Geijn3 , D. Van Zeben1 1 Afdeling reumatologie 2 Afdeling interne geneeskunde 3 Afdeling Klinische Chemie 4 Leerhuis van het Sint Franciscus Gasthuis Rotterdam. INLEIDING: Het is bekend dat het ontstaan van atherosclerose een inflammatoir proces is. Op basis hiervan wordt verondersteld dat chronisch inflammatoire ziektes zoals reumatoïde 113 , T.L Njo3 , C. van Casteren-Messidoro1 , J.W.Janssen3 , E. Birnie4 , B. Klop2 , R.Bakker3 , N. Verwer, A.M. , M. Castro WETENSCHAPPELIJK jaarverslag 2012 Pagina 112
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