RT Journal Article SR Electronic T1 Clenbuterol: a new toxic substance in paediatrics JF BMJ Case Reports JO BMJ Case Reports FD BMJ Publishing Group Ltd SP e233180 DO 10.1136/bcr-2019-233180 VO 13 IS 3 A1 Andrew A Tester A1 Sheena Logan A1 Louisa Pollock A1 Allison McKie YR 2020 UL http://casereports.bmj.com/content/13/3/e233180.abstract AB A 13-year-old girl presented to the emergency department with acute onset of chest pain, nausea and tremor. The patient denied drug ingestion, and urine toxicology was negative. ECG demonstrated sinus tachycardia, prolonged QTc (541 ms) and ST depression. Laboratory testing demonstrated metabolic acidosis, hypokalaemia, hypophosphataemia and hyperglycaemia. She was commenced on continuous cardiac monitoring and treated with intravenous fluids and electrolyte replacement. Presenting features and laboratory abnormalities resolved within 48 hours. The National Poisons Information Service and Clinical Biochemistry were integral to her management, advising the clinical team on the likeliest aetiology. Five weeks after discharge, urine toxicology, using mass spectrometry, identified clenbuterol. Clenbuterol is an oral β2-agonist with anabolic and lipolytic effects that is misused as a performance and image enhancing drug. Clinicians must be aware of the increasing availability of these drugs and their potential for causing harm in children and adolescents.