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Hulk-Like Urine: A Case of Green Urine Caused by Flupirtine Intoxication

Acute intoxications are common causes of admission to the Emergency Department (ED). Flupirtine is a non-opioid analgesic, originally used for acute and chronic pain. Because of several reports of severe liver toxicity, its use was limited to acute pain in 2013 by the European Medicines Agency. Alth...

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Autores principales: Vilela, Maria, Fernandes, Diana, Salazar, Tatiana, Duarte, Augusto
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7839280/
https://www.ncbi.nlm.nih.gov/pubmed/33520530
http://dx.doi.org/10.7759/cureus.12333
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author Vilela, Maria
Fernandes, Diana
Salazar, Tatiana
Duarte, Augusto
author_facet Vilela, Maria
Fernandes, Diana
Salazar, Tatiana
Duarte, Augusto
author_sort Vilela, Maria
collection PubMed
description Acute intoxications are common causes of admission to the Emergency Department (ED). Flupirtine is a non-opioid analgesic, originally used for acute and chronic pain. Because of several reports of severe liver toxicity, its use was limited to acute pain in 2013 by the European Medicines Agency. Although withdrawn from the European market in March 2018, there are still flupirtine tablets in many households, and most people are unaware of the hazards they might be facing. A 58-year-old man was admitted to the ED after a suicide attempt with 1 g of flupirtine. He was lethargic and confused but presented no focal neurological deficits or other symptoms, and the rest of his clinical examination was unremarkable. His cerebral CAT and blood chemistry showed no alterations. The only remarkable feature was that he had green urine. After a careful literature search, a similar case was found caused by flupirtine intoxication. After 24 hours of vigilance in the ED, he improved his neurological status and his urine lost part of its greenish color. He was then transferred to the Psychiatric Department, where he presented a complete remission of the clinical alterations. A follow-up check-up showed no permanent deficits.
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spelling pubmed-78392802021-01-29 Hulk-Like Urine: A Case of Green Urine Caused by Flupirtine Intoxication Vilela, Maria Fernandes, Diana Salazar, Tatiana Duarte, Augusto Cureus Emergency Medicine Acute intoxications are common causes of admission to the Emergency Department (ED). Flupirtine is a non-opioid analgesic, originally used for acute and chronic pain. Because of several reports of severe liver toxicity, its use was limited to acute pain in 2013 by the European Medicines Agency. Although withdrawn from the European market in March 2018, there are still flupirtine tablets in many households, and most people are unaware of the hazards they might be facing. A 58-year-old man was admitted to the ED after a suicide attempt with 1 g of flupirtine. He was lethargic and confused but presented no focal neurological deficits or other symptoms, and the rest of his clinical examination was unremarkable. His cerebral CAT and blood chemistry showed no alterations. The only remarkable feature was that he had green urine. After a careful literature search, a similar case was found caused by flupirtine intoxication. After 24 hours of vigilance in the ED, he improved his neurological status and his urine lost part of its greenish color. He was then transferred to the Psychiatric Department, where he presented a complete remission of the clinical alterations. A follow-up check-up showed no permanent deficits. Cureus 2020-12-28 /pmc/articles/PMC7839280/ /pubmed/33520530 http://dx.doi.org/10.7759/cureus.12333 Text en Copyright © 2020, Vilela et al. http://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Emergency Medicine
Vilela, Maria
Fernandes, Diana
Salazar, Tatiana
Duarte, Augusto
Hulk-Like Urine: A Case of Green Urine Caused by Flupirtine Intoxication
title Hulk-Like Urine: A Case of Green Urine Caused by Flupirtine Intoxication
title_full Hulk-Like Urine: A Case of Green Urine Caused by Flupirtine Intoxication
title_fullStr Hulk-Like Urine: A Case of Green Urine Caused by Flupirtine Intoxication
title_full_unstemmed Hulk-Like Urine: A Case of Green Urine Caused by Flupirtine Intoxication
title_short Hulk-Like Urine: A Case of Green Urine Caused by Flupirtine Intoxication
title_sort hulk-like urine: a case of green urine caused by flupirtine intoxication
topic Emergency Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7839280/
https://www.ncbi.nlm.nih.gov/pubmed/33520530
http://dx.doi.org/10.7759/cureus.12333
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