Exploring Endotoxemia in Age-Related Macular Degeneration, Glaucoma, and Diabetic Retinopathy.

Loxoprofen is a prodrug converted in the liver by carbonyl reductase enzymes into trans- and cis-hydroxylated metabolites []. The active metabolite, trans-OH, exerts anti-inflammatory effects by inhibiting cyclooxygenase and suppressing prostaglandin synthesis [, ]. Although loxoprofen is known to cause adverse effects such as renal and hepatic dysfunction and gastrointestinal disturbances [], reports of overdose are extremely limited. Although a previous report described a patient who was asymptomatic at presentation but later developed toxicity [], there is no published no report of a patient remaining asymptomatic without organ dysfunction despite elevated plasma concentrations of loxoprofen. Herein, we report a case of massive loxoprofen ingestion in which high plasma concentrations of loxoprofen and its metabolites were confirmed through liquid chromatography–mass spectrometry (LC/MS), but no toxic symptoms or organ dysfunction were observed. A 43-year-old Japanese woman (72 kg, 151 cm) intentionally ingested 8,280 mg of loxoprofen (138 tablets of Loxonin 60 mg). Her family noticed that she had ingested an excessive amount of loxoprofen and called emergency medical services: she was transported to our hospital approximately two hours later. The patient had not consumed alcohol at the time of loxoprofen ingestion. Her medical history included bipolar disorder, and she had used loxoprofen intermittently prior to this overdose, although the exact duration of use was unknown.