A Case of Salicylate Intoxication Complicated by Coagulopathy, Pulmonary Edema, and Pancreatitis.

The large availability of salicylic acid products makes them an often encountered source of poisoning in the emergency department. Even though in most cases the prognosis is good, with a low incidence of long-term morbidity and mortality, complications do occur, and some of those can be life threatening. We present an unusual case of salicylate intoxication in an adolescent in which several uncommon complications (severe coagulopathy, pulmonary edema, and pancreatitis) conjoined together. We review the literature and discuss the complications pathogenesis and differential diagnosis. We suggest that these potentially life-threatening complications be acknowledged, investigated, and rapidly treated.

[1]  R. Gorantla,et al.  Salicylate-induced pulmonary edema--a near-miss diagnosis. , 2014, The American journal of emergency medicine.

[2]  D. Spyker,et al.  2012 Annual Report of the American Association of Poison Control Centers’ National Poison Data System (NPDS): 30th Annual Report , 2013, Clinical toxicology.

[3]  J. Mayerle,et al.  Drug-Induced Pancreatitis , 2012, Current Gastroenterology Reports.

[4]  A. Woolf,et al.  Salicylate poisoning: An evidence-based consensus guideline for out-of-hospital management , 2007, Clinical toxicology.

[5]  D. Karamanolis,et al.  A case of acute pancreatitis possibly associated with combined salicylate and simvastatin treatment. , 2005, JOP : Journal of the pancreas.

[6]  M. Foster,et al.  Chronic salicylism resulting in noncardiogenic pulmonary edema requiring hemodialysis. , 2000, American journal of kidney diseases : the official journal of the National Kidney Foundation.

[7]  J. Suttie,et al.  The effects of salicylate on enzymes of vitamin K metabolism , 1983, The Journal of pharmacy and pharmacology.

[8]  C. Stelling,et al.  Salicylate-induced pulmonary edema. , 1983, Radiology.

[9]  B. K. Park,et al.  On the mechanism of salicylate‐induced hypothrombinaemia , 1981, The Journal of pharmacy and pharmacology.

[10]  F. Barbier,et al.  Salicylate-induced pancreatitis. , 1981, Gastroenterology.

[11]  Benians Rc.  Severely disturbed adolescents. , 1970 .

[12]  S. Sussman.  Severe salicylism and acute pancreatitis. , 1963, California medicine.

[13]  K. Granville-Grossman,et al.  Pulmonary oedema due to salicylate intoxication. , 1960, Lancet.