A FATAL OVERDOSE OF ARGININE HYDROCHLORIDE

Case Report: Arginine hydrochloride is used both diagnostically to tes t for growth hormone deficiency and therapeutically for treatment of m etabolic alkalosis. We describe a 21-month-old girl who developed card iopulmonary arrest following an accidental overdose of arginine hydroc hloride. The patient developed acute metabolic acidosis and transient, but severe, hyponatremia. Thirty-six hours after successful resuscita tion, she developed fatal central pontine and extrapontine myelinolysi s. Unlike previous reports of arginine toxicity, our patient showed no evidence of hyperkalemia. This case illustrates a previously unreport ed mechanism of arginine hydrochloride toxicity.