Guanfacine poisoning resulting in transient ST‐segment elevation: a case report
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Title
Guanfacine poisoning resulting in transient ST‐segment elevation: a case report
Subject
Attention-deficit hyperactivity disorder, Guanfacine, Poisoning, ST-segment elevation
Description
Background Guanfacine is an alpha-2 adrenergic agonist that decreases norepinephrine release and sympathetic
outflow. With the increased use of guanfacine for attention-deficit hyperactivity disorder (ADHD), reports of guanfa-
cine poisoning have also risen.
Case presentation A 15-year-old male (height: 170 cm, weight: 48 kg), who was taking 2 mg/day of guanfacine
for ADHD, was brought to our emergency department after ingesting 40 tablets of guanfacine due to poor exam
results. He presented with impaired consciousness and sinus bradycardia on an electrocardiogram (ECG), leading
to diagnosis of guanfacine poisoning. Gastric lavage (5 L) was performed, and activated charcoal was adminis-
tered. Although his consciousness gradually recovered, he developed ST-segment elevation on the ECG. Despite
the absence of chest pain and elevated myocardial enzymes, coronary artery stenosis was not observed on coronary
artery computed tomography. As his blood guanfacine level decreased, his ECG returned to normal.
Conclusions This case highlights the need for careful monitoring of guanfacine poisoning patients due to the poten-
tial for various cardiovascular events.
Keywords Attention-deficit hyperactivity disorder, Guanfacine, Poisoning, ST-segment elevation
outflow. With the increased use of guanfacine for attention-deficit hyperactivity disorder (ADHD), reports of guanfa-
cine poisoning have also risen.
Case presentation A 15-year-old male (height: 170 cm, weight: 48 kg), who was taking 2 mg/day of guanfacine
for ADHD, was brought to our emergency department after ingesting 40 tablets of guanfacine due to poor exam
results. He presented with impaired consciousness and sinus bradycardia on an electrocardiogram (ECG), leading
to diagnosis of guanfacine poisoning. Gastric lavage (5 L) was performed, and activated charcoal was adminis-
tered. Although his consciousness gradually recovered, he developed ST-segment elevation on the ECG. Despite
the absence of chest pain and elevated myocardial enzymes, coronary artery stenosis was not observed on coronary
artery computed tomography. As his blood guanfacine level decreased, his ECG returned to normal.
Conclusions This case highlights the need for careful monitoring of guanfacine poisoning patients due to the poten-
tial for various cardiovascular events.
Keywords Attention-deficit hyperactivity disorder, Guanfacine, Poisoning, ST-segment elevation
Creator
Ichiro Hirayama1,2*, Yoshito Kamijo1
, Hiroko Abe1,3, Minaho Nonaka2
, Tetsuhiro Yano2
, Mitsuru Ishii2 and
Yoshiteru Tominaga2
, Hiroko Abe1,3, Minaho Nonaka2
, Tetsuhiro Yano2
, Mitsuru Ishii2 and
Yoshiteru Tominaga2
Source
https://doi.org/10.1186/s12245-024-00634-0
Date
2024
Contributor
Peri Irawan
Format
pdf
Language
english
Type
text
Files
Collection
Citation
Ichiro Hirayama1,2*, Yoshito Kamijo1
, Hiroko Abe1,3, Minaho Nonaka2
, Tetsuhiro Yano2
, Mitsuru Ishii2 and
Yoshiteru Tominaga2, “Guanfacine poisoning resulting in transient ST‐segment elevation: a case report,” Repository Horizon University Indonesia, accessed April 11, 2026, https://repository.horizon.ac.id/items/show/12341.