J Korean Soc Emerg Med.  2014 Jun;25(3):323-326.

A Case of Severe Digoxin Intoxication Treated with Digoxin Immune Fab

• Kim ST
• Lim YS
• Park WB
• Woo JH
• Jang JH

Abstract

Digoxin is commonly used in treatment of various heart conditions, such as atrial fibrillation, atrial flutter, and sometimes heart failure. The therapeutic range of digoxin is narrow. Therefore, Digoxin toxicity is common. However, severe digoxin intoxication is uncommon. Many cases involving application of Digoxin immune Fab for digoxin intoxication in other countries have been reported. However, no cases have been reported in Korea. We reported on one case, a 34-year-old male with acute and severe digoxin intoxication who was treated with digibind(R). His chief complaint was gastrointestinal symptoms, including nausea and vomiting. Electrocardiography (ECG) showed third degree atrioventricular (AV) block. After an infusion of digibind(R), third degree AV block rhythm was changed to first degree AV block. Nowadays, we can obtain a digoxin antidote from the national poisoning information center. Therefore, we should actively consider application of Digoxin immune Fab in patients with severe digoxin intoxication.

Keyword

Digoxin; Digoxin antibodies Fab fragments

MeSH Terms

Adult
Atrial Fibrillation
Atrial Flutter
Atrioventricular Block
Digoxin*
Electrocardiography
Heart
Heart Failure
Humans
Information Centers
Korea
Male
Nausea
Poisoning
Vomiting
Digoxin