Abstract:

Objective To investigate the clinical characteristics, treatment strategy, and warning implications of severe pregabalin poisoning. Methods A retrospective analysis was performed on the clinical data of a 19-year-old male patient who developed severe intoxication after intentional ingestion of a large dose of pregabalin (2400 mg, 42.9 mg/kg). The clinical manifestations, laboratory findings, diagnostic process, treatment, and outcome were summarized. Results After medication ingestion, the patient developed progressive disturbance of consciousness and was in deep coma on admission (Glasgow Coma Scale [GCS] score of 6). Laboratory tests revealed hyperuricemia (746 μmol/L), progressive thrombocytopenia (nadir 64×10⁹/L), and a marked increase in D-dimer (peak 14.56 mg/L). Imaging examinations showed no obvious abnormalities. After gastric lavage, hemoperfusion combined with continuous renal replacement therapy, and comprehensive supportive treatment, the patient regained consciousness within 3 d. Platelet count and coagulation function gradually returned to normal. He was discharged smoothly on hospital day 4 and had no sequelae during 3-month follow-up. Conclusion Severe pregabalin poisoning can cause serious disturbance of consciousness and coagulation abnormalities. Early combined hemoperfusion and continuous renal replacement therapy is an effective strategy for critically poisoned patients. Clinicians should pay close attention to the risk of pregabalin abuse in adolescents and strengthen medication assessment and monitoring.

Key words: poisoning, pregabalin, coma, thrombocytopenia, hemoperfusion, continuous renal replacement therapy, drug abuse