# Rhabdomyolysis secondary to chlorpheniramine maleate toxicity: a case report

## TL;DR

A 14-year-old girl developed rhabdomyolysis after taking a large dose of chlorpheniramine maleate, a common antiallergic drug.

## Contribution

This case report highlights rhabdomyolysis as a rare but possible complication of chlorpheniramine maleate toxicity.

## Key findings

- The patient showed elevated myoglobin and creatine kinase levels, indicating muscle damage.
- The patient's condition improved after treatment with decontamination, diuresis, and electrolyte balance.
- Other markers like troponin and creatinine remained normal, suggesting no cardiac or kidney damage.

## Abstract

Chlorpheniramine maleate is a commonly used antiallergic drug; excessive ingestion can cause adverse effects such as hallucinations, tachycardia, central nervous system depression, and organ dysfunction. However, rhabdomyolysis induced by this drug is rarely reported. This study presents a case of rhabdomyolysis secondary to chlorpheniramine maleate poisoning.

A 14-year-old female student developed palpitations after oral ingestion of 100 tablets of chlorpheniramine maleate (4 mg per tablet). Six hours post-ingestion, laboratory tests showed elevated concentrations of myoglobin (>1,200 ng/mL) and creatine kinase (1529.7 U/L). Nine hours post-ingestion, the myoglobin concentration gradually decreased to 889 ng/mL, while the creatine kinase concentration continued to rise to 7,315 U/L. One day after ingestion, the myoglobin concentration further decreased, whereas the creatine kinase concentration peaked at 11,219 U/L. Indicators including troponin, creatine kinase-MB mass, serum creatinine, and serum uric acid remained within the normal range. Following treatment with gastrointestinal decontamination, diuresis, and maintenance of electrolyte balance, the patient’s condition improved and she was discharged.

Chlorpheniramine maleate poisoning can cause hallucinations, hypertension, tachycardia, organ dysfunction, and central nervous system depression. Additionally, it may be a potential etiological factor for rhabdomyolysis.