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Abstract
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Minoxidil is widely used as a topical medication for alopecia and has now become an easily available over-the-counter medication that is sold as a cosmetic.1 However, it is a very potent vasodilator and is used to manage refractory hypertension.2 Its consumption can lead to life-threatening complications.
A 12-year-old girl was brought to the Emergency Department by her two brothers with complaints of repeated vomiting with some fresh and altered blood. She gave the history of severe headaches involving both sides of the head and giddiness on standing up. There was no history of any pain abdomen or melena, visual disturbance, fever, breathlessness, or palpitation. She had no history of migraine or any cardiac ailment. Both she and her attendants denied a history of ingestion of any poison. On examination she had severe tachycardia (150/min), hypotension (70/38 mm Hg), and tachypnoea but no orthopnoea. She had cold clammy peripheries but there was no pallor or cyanosis. Her systemic examination was unremarkable.
Resuscitative measures were instituted with a rapid intravenous infusion of 1.5 l of normal saline. A Ryle's tube (RT) was inserted, and stomach wash given. The Ryle's tube aspirate was clear and had no abnormal odour. Despite fluid replacement, her hypotension and tachycardia persisted. Electrocardiogram (ECG) done on admission revealed ST segment elevation in aVR, ST depression in all leads and T wave inversion in precordial leads (Fig. 1). Her bedside 2D Echo was normal.
Repeated interrogation of the attendants revealed that following an altercation at home, she had consumed 20 mL of Minicize from the cosmetic cupboard. The solution was Minoxidil.
Language: en |