[A baby with digoxin toxicity]

Accidental poisoning or overdoses occur frequently in children. These are difficult to recognise because young children cannot communicate their symptoms; this means that specific symptoms can be missed, which can delay the diagnosis. A 5-month-old boy was accidently given a tenfold dose of digoxin for 5 days. He developed feeding difficulties, vomiting, weight loss, elevated urea and creatinine levels, hyponatraemia, hyperkalaemia and ECG abnormalities. The digoxin plasma concentration was 7.6 µg/l. The patient was given digoxin antibodies, following which the digoxin concentration was0.3 µg/l; 12 hours later the digoxin concentration was 3.1 µg/l as a result of redistribution; 2 days after the administration of digoxin antibodies the plasma concentration was within the therapeutic range.