Annals of Tropical Paediatrics International Child Health
ISSN: 0272-4936 (Print) 1465-3281 (Online) Journal homepage: http://www.tandfonline.com/loi/ypch19
Occurrence of chloroquine-induced psychotic manifestations in children with malaria Suraj Gupte To cite this article: Suraj Gupte (1992) Occurrence of chloroquine-induced psychotic manifestations in children with malaria, Annals of Tropical Paediatrics, 12:2, 229-229, DOI: 10.1080/02724936.1992.11747574 To link to this article: http://dx.doi.org/10.1080/02724936.1992.11747574
Published online: 13 Jul 2016.
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Date: 31 August 2017, At: 18:43
Annals of Tropical Paediam·cs ( 1992) 12, 229-230
Letters to the Editor
Downloaded by [Australian Catholic University] at 18:43 31 August 2017
Occurrence of chloroquine-induced psychotic manifestations in children with malaria SIR-The occurrence of chloroquineinduced psycho tic manifestations in children suffering from malaria has only recently been reported in India. 1- 4 A precise clinical spectrum of such manifestations is as yet far from clear. 3 Recently, we encountered two siblings, a girl of 6 years and her brother, 9, who presented with bizarre disturbances which took the form of visual hallucinations in connection with shape, size, colour and reciprocal position of objects-the so-called 'Alice in Wonderland' syndrome-a few days after the administration of single doses of chloroquine for suspected malaria. Following administration of diazepam orally, these symptoms disappeared completely, 3 days in the first case and 5 days in the second case. The possibility that chloroquine consumption may be implicated in the occurrence of the 'Alice in Wonderland' syndrome and other psychotic manifestations in childhood must be borne in mind in tropical and subtropical regions where malaria continues to be endemie. SURAJ GUPTE Head of the Unit, Children's Hospital, Government Medical Co/lege, Jammu 180005, India.
References 1 Bhatia MS, Singhal PK, Dhar NK. Chloroquineinduced psychosis. Indian Pediatr 1988; 25:258-62. 2 Agarwal A, Agarwal R. Chloroquine-induced psychosis. lndian Pediatr 1988; 25:1226-7. 3 Gupte S. Parasitie infections and infestations. In: The Short Textbook of Pediatries, 6th edn. New Delhi: Jaypee, 1989; 125-34.
4 Gupte S, Smith R. Drugs commonly used in pediatrie practiee. ln: Pediatrie Drug Directory, 6th edn. New Delhi: Jaypee, 1991; 1-82.
Electrocardiographie changes in measles SrR-Olowu and Taiwo's paper on electrocardiographie changes in measles 1 makes interesting reading. In this context, 1 take this opportunity to recall a similar study we conducted several years ago 2 on North Indian infants and children. Of the 62 cases of measles studied, 33 showed clear-cut ECG changes, the most dominant being T -wave inversion and prolonged P-R interval. Only two of the subjects, however, had significant evidence of myocarditis. The majority of our patients were over 1 year of age but the incidence of ECG changes was highest in the under-1year-of-age group. With the exception of one infant with overt myocarditis who died, ali the children recovered with complete disappearance of ECG changes within 10-21 days. No cardiological sequelae-clinical or ECG-were detected in 13 children who we were able to follow up for more than 6 months. We wish to stress that, although the incidence of overt cardiac involvement in measles is indeed low, subclinical myocarditis evidenced by ECG changes occurs in many children with the disease, especially infants. As a rule, the ECG changes are only transient. Our published observations have been supported by our experience in subsequent years. 3 SURAJ GUPTE Head of the Unit, Children's Hospital, Government Medical Co/lege, Jammu 180005, India.
ISSN: 0272-4936 (Print) 1465-3281 (Online) Journal homepage: http://www.tandfonline.com/loi/ypch19
Occurrence of chloroquine-induced psychotic manifestations in children with malaria Suraj Gupte To cite this article: Suraj Gupte (1992) Occurrence of chloroquine-induced psychotic manifestations in children with malaria, Annals of Tropical Paediatrics, 12:2, 229-229, DOI: 10.1080/02724936.1992.11747574 To link to this article: http://dx.doi.org/10.1080/02724936.1992.11747574
Published online: 13 Jul 2016.
Submit your article to this journal
Article views: 1
View related articles
Full Terms & Conditions of access and use can be found at http://www.tandfonline.com/action/journalInformation?journalCode=ypch19 Download by: [Australian Catholic University]
Date: 31 August 2017, At: 18:43
Annals of Tropical Paediam·cs ( 1992) 12, 229-230
Letters to the Editor
Downloaded by [Australian Catholic University] at 18:43 31 August 2017
Occurrence of chloroquine-induced psychotic manifestations in children with malaria SIR-The occurrence of chloroquineinduced psycho tic manifestations in children suffering from malaria has only recently been reported in India. 1- 4 A precise clinical spectrum of such manifestations is as yet far from clear. 3 Recently, we encountered two siblings, a girl of 6 years and her brother, 9, who presented with bizarre disturbances which took the form of visual hallucinations in connection with shape, size, colour and reciprocal position of objects-the so-called 'Alice in Wonderland' syndrome-a few days after the administration of single doses of chloroquine for suspected malaria. Following administration of diazepam orally, these symptoms disappeared completely, 3 days in the first case and 5 days in the second case. The possibility that chloroquine consumption may be implicated in the occurrence of the 'Alice in Wonderland' syndrome and other psychotic manifestations in childhood must be borne in mind in tropical and subtropical regions where malaria continues to be endemie. SURAJ GUPTE Head of the Unit, Children's Hospital, Government Medical Co/lege, Jammu 180005, India.
References 1 Bhatia MS, Singhal PK, Dhar NK. Chloroquineinduced psychosis. Indian Pediatr 1988; 25:258-62. 2 Agarwal A, Agarwal R. Chloroquine-induced psychosis. lndian Pediatr 1988; 25:1226-7. 3 Gupte S. Parasitie infections and infestations. In: The Short Textbook of Pediatries, 6th edn. New Delhi: Jaypee, 1989; 125-34.
4 Gupte S, Smith R. Drugs commonly used in pediatrie practiee. ln: Pediatrie Drug Directory, 6th edn. New Delhi: Jaypee, 1991; 1-82.
Electrocardiographie changes in measles SrR-Olowu and Taiwo's paper on electrocardiographie changes in measles 1 makes interesting reading. In this context, 1 take this opportunity to recall a similar study we conducted several years ago 2 on North Indian infants and children. Of the 62 cases of measles studied, 33 showed clear-cut ECG changes, the most dominant being T -wave inversion and prolonged P-R interval. Only two of the subjects, however, had significant evidence of myocarditis. The majority of our patients were over 1 year of age but the incidence of ECG changes was highest in the under-1year-of-age group. With the exception of one infant with overt myocarditis who died, ali the children recovered with complete disappearance of ECG changes within 10-21 days. No cardiological sequelae-clinical or ECG-were detected in 13 children who we were able to follow up for more than 6 months. We wish to stress that, although the incidence of overt cardiac involvement in measles is indeed low, subclinical myocarditis evidenced by ECG changes occurs in many children with the disease, especially infants. As a rule, the ECG changes are only transient. Our published observations have been supported by our experience in subsequent years. 3 SURAJ GUPTE Head of the Unit, Children's Hospital, Government Medical Co/lege, Jammu 180005, India.
