Hemoadsorption for refractory shock after amlodipine intoxication: a case report

BACKGROUND: Dihydropyridine calcium channel blockers are commonly prescribed to treat hypertension. In overdose they can induce cardiovascular collapse and multiorgan dysfunction with very lethal outcomes. Modern resin hemoadsorption devices can be useful for enhancing the elimination of these drugs in refractory cases. CASE PRESENTATION: The authors present the case of a Caucasian male in his 70 s who intentionally ingested 150 mg of amlodipine and was subsequently admitted to the intensive care unit with refractory vasoplegic shock. Drug clearance using hemoadsorption was attempted via the use of a styrene resin filter (Jafron HA230) with concurrent hemodynamic stabilization and successful patient outcome. CONCLUSIONS: This case highlights a possible emerging role of HA therapy in mitigating toxic effects of protein and lipid-bound toxins in severe poisoning. Further research is essential to define standardized guidelines for its use in managing drug toxicity.