A Case of Unusual Oral Theophylline Toxicity

Abstract

Theophylline is a methylxanthine medicine used for treatment of bronchospasm in asthma and COPD. This reports illustrates a case where a patient was taking oral theophylline for COPD, was admitted to hospital with confirmed COVID-19 and subsequently developed a combination of vague signs, symptoms and biochemistry results, such as confusion, sinus tachycardia, compensated metabolic acidosis, hypomagnesaemia and refractory hypokalaemia. These non-specific signs and symptoms were initially attributed to other causes such as infection; however subsequent review of the patient's medication suggested that theophylline toxicity could be the cause. These non-specific signs and symptoms were present despite normal plasma aminophylline level and resolved once treatment with oral theophylline was ceased.