Baclofen Toxicity in Children With Acute Kidney Injury: Case Reports and Review of the Literature

Baclofen is a medication used for tone management in cerebral palsy. Although it acts mainly at the spinal cord level, it can cause central nervous system adverse reactions at higher doses. Baclofen is mainly eliminated by renal excretion and there have been reports on adverse events when used in ad...

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Main Authors:	Ram A. Mishaal MD, Nancy E. Lanphear MD, Erez Armarnik MD, Esias R. van Rensburg MD, Douglas G. Matsell MD
Format:	Article
Language:	English
Published:	SAGE Publishing 2020-06-01
Series:	Child Neurology Open
Online Access:	https://doi.org/10.1177/2329048X20937113

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spelling	doaj-319db07c57814e12a070d47114d29c462020-11-25T03:20:33ZengSAGE PublishingChild Neurology Open2329-048X2020-06-01710.1177/2329048X20937113Baclofen Toxicity in Children With Acute Kidney Injury: Case Reports and Review of the LiteratureRam A. Mishaal MD0Nancy E. Lanphear MD1Erez Armarnik MD2Esias R. van Rensburg MD3Douglas G. Matsell MD4 Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, CanadaBaclofen is a medication used for tone management in cerebral palsy. Although it acts mainly at the spinal cord level, it can cause central nervous system adverse reactions at higher doses. Baclofen is mainly eliminated by renal excretion and there have been reports on adverse events when used in adults with renal impairment; however, there are no consensus guidelines as to the dose adjustments required due to renal impairment. The authors describe 2 children with acute kidney injury (AKI) and systemic side effects with initiation of oral baclofen, which was started for treatment of dystonia/spasticity in the recovery phase of their kidney injury. Following the initiation of the drug, they both had decreased level of consciousness and respiratory difficulties, which warranted discontinuation of the drug. These cases highlight the need for reduced initial dose, slow titration, and close monitoring when initiating baclofen treatment in children with AKI.https://doi.org/10.1177/2329048X20937113
collection	DOAJ
language	English
format	Article
sources	DOAJ
author	Ram A. Mishaal MD Nancy E. Lanphear MD Erez Armarnik MD Esias R. van Rensburg MD Douglas G. Matsell MD
spellingShingle	Ram A. Mishaal MD Nancy E. Lanphear MD Erez Armarnik MD Esias R. van Rensburg MD Douglas G. Matsell MD Baclofen Toxicity in Children With Acute Kidney Injury: Case Reports and Review of the Literature Child Neurology Open
author_facet	Ram A. Mishaal MD Nancy E. Lanphear MD Erez Armarnik MD Esias R. van Rensburg MD Douglas G. Matsell MD
author_sort	Ram A. Mishaal MD
title	Baclofen Toxicity in Children With Acute Kidney Injury: Case Reports and Review of the Literature
title_short	Baclofen Toxicity in Children With Acute Kidney Injury: Case Reports and Review of the Literature
title_full	Baclofen Toxicity in Children With Acute Kidney Injury: Case Reports and Review of the Literature
title_fullStr	Baclofen Toxicity in Children With Acute Kidney Injury: Case Reports and Review of the Literature
title_full_unstemmed	Baclofen Toxicity in Children With Acute Kidney Injury: Case Reports and Review of the Literature
title_sort	baclofen toxicity in children with acute kidney injury: case reports and review of the literature
publisher	SAGE Publishing
series	Child Neurology Open
issn	2329-048X
publishDate	2020-06-01
description	Baclofen is a medication used for tone management in cerebral palsy. Although it acts mainly at the spinal cord level, it can cause central nervous system adverse reactions at higher doses. Baclofen is mainly eliminated by renal excretion and there have been reports on adverse events when used in adults with renal impairment; however, there are no consensus guidelines as to the dose adjustments required due to renal impairment. The authors describe 2 children with acute kidney injury (AKI) and systemic side effects with initiation of oral baclofen, which was started for treatment of dystonia/spasticity in the recovery phase of their kidney injury. Following the initiation of the drug, they both had decreased level of consciousness and respiratory difficulties, which warranted discontinuation of the drug. These cases highlight the need for reduced initial dose, slow titration, and close monitoring when initiating baclofen treatment in children with AKI.
url	https://doi.org/10.1177/2329048X20937113
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Baclofen Toxicity in Children With Acute Kidney Injury: Case Reports and Review of the Literature

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