PEDIATRICS Vol. 69 No. 4 April 1982, pp. 476-480
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Altered Theophylline Clearance During an Influenza B Outbreak

Michael J. Kraemer MD1, Clifton T. Furukawa MD1, Jeffrey R. Koup PharmD1, Gail G. Shapiro MD1, William E. Pierson MD1, and C. Warren Bierman MD1

1 Department of Pediatrics, University of Washington School of Medicine, the Children's Orthopedic Hospital and Medical Center, and Associated Scientists to Help Minimize Allergies (ASTHMA) Inc, Seattle

During the 1980 influenza B outbreak in King County, Washington, 11 children whose asthma had previously been controlled with a stable theophylline dose, developed theophylline toxicity on this same dose. Two had seizures, eight had nausea and vomiting, and three had headaches. All had clinical evidence of a febrile viral illness. The toxicity appeared to be related to decreased theophylline clearance, which gradually returned to preillness levels over a period of one to three months. Six of ten children had serologic evidence of influenza B, which is presumed to be the cause of the altered clearance. In children receiving chronic theophylline therapy, symptoms of vomiting, headaches, or seizures during a viral illness may be due to theophylline toxicity rather than the virus. Such patients should have an immediate serum theophylline determination, even if previous levels have been in the therapeutic range.

Submitted on December 29, 1980
Accepted on May 19, 1981


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