Abstract
Around 4,600 caffeine overdose cases a year have been reported in the US. However, it is relatively uncommon in Japan. The caffeine overdose is associated with life-threatening hemodynamic and neurological complications. In this paper, we report a case of caffeine overdose that was successfully treated with hemodialysis. A 26-year-old male took 25 g of caffeine to commit suicide and was taken by ambulance to our hospital. The patient was agitated and presented with tachycardia, tachypnea, muscle rigidity, tremor, and vomiting on admission. Electrocardiography revealed multifocal ventricular tachycardia (VT). The lethal dose of caffeine is about 10 grams and its half-life is 3 to 7 hours. Since the VT was refractory to lidocaine and the dose of his caffeine intake was high enough to give rise to hemodynamic collapse and persistent arrhythmia, we performed hemodialysis on this patient. After the hemodialysis, arrhythmia and other symptoms due to caffeine overdose rapidly disappeared, and the patient was discharged without any complications. Based on the clinical course we experienced, an early induction of hemodialysis is thought to be an effective treatment for a patient presenting with caffeine overdose.
