Reelevated blood caffeine level due to intestinal reabsorption in a patient with caffeine intoxication

Acute caffeine intoxication by an overdose shows a dose-dependent response and its symptoms and mechanism are similar to those of acute intoxication caused by theophylline, which is also a xanthine derivative. We experienced a case of acute caffeine intoxication with a lethal dose and performed hemodialysis (HD) to improve the addiction. We examined a therapeutic strategy based on changes in blood levels of caffeine and theophylline, which is an intermediate metabolite, during the course of HD. The blood levels of caffeine and theophylline showed different trends in the early period of internal use. After HD, the blood levels of caffeine and theophylline showed similar trends including the time when the blood levels of caffeine rose again due to intestinal reabsorption. Theophylline may be a useful indicator of re-increase in blood concentration due to a drug overdose.