Olanzapine
- PDF / 143,424 Bytes
- 1 Pages / 595.245 x 841.846 pts (A4) Page_size
- 49 Downloads / 177 Views
S
Neuroleptic malignant syndrome-like conditions: 3 case reports
1
Kadirolu AK, et al. Three patients with neuroleptic malignant syndrome: Differential diagnosis and the causes of predisposition. Journal of Medical and Surgical Intensive Care Medicine 2: 67-70, No. 3, Jan 2011. Available from: URL: http://dx.doi.org/10.5152/dcbybd.2011.15 [Turkish; summarised from a translation] 803076288 - Turkey
Three women were admitted with a diagnosis of a neuroleptic malignant syndrome (NMS)-like condition related to olanzapine [routes and dosages not stated]. A 48-year-old woman with schizophrenia had been receiving olanzapine for 1.5 years when she was hospitalised with fever, loss of appetite, breathing difficulties, sweating, constant sleepiness and an oral intake problem. Her Glasgow Coma Scale (GCS) score was 13. On physical examination, her vital signs were as follows: body temperature 39.6°C, HR 122 beats/min, BP 80/50mm Hg and respiratory rate 22 breaths/min. She also had lower extremity rigidity, pale conjunctiva and rales in her right lung. Laboratory investigations included the following: leukocyte count 3410 k/µL, haemoglobin 9.9 g/dL, haematocrit 30.5%, platelet count 96 800 k/µL, urea 102 mg/dL, creatinine 1.6 mg/dL, CK 2008 mg/dL, sedimentation rate 80 mm/h, CRP 15.2 mg/dL, reticulocyte index 0.4 and vitamin B12 92. Tests revealed infiltrations in the mid region of the right lung. A peripheral blood smear showed hypersegmented neutrophils, macrocytic erythrocytes, increased numbers of band neutrophils and toxic granulation. She was found to have megaloblastic anaemia, acute kidney failure and community acquired pneumonia. Following treatment with fluids, tazobactam, piperacillin and vitamin B12, her condition improved. However, her symptoms could not be explained solely by a diagnosis of NMS. A 30-year-old woman was diagnosed with schizophrenia and began receiving olanzapine. Four years later, she presented with hypersomnia, communication difficulties, body aches, clouding of consciousness, fever and inability to move her hands and arms. She was hospitalised with a pre-diagnosis of NMS. She had a GCS score of 11, with the following vital signs: body temperature 38.3°C, HR 108 beats/min, BP 90/50mm Hg and respiratory rate 14 breaths/min. She also had upper and lower extremity rigidity and a decubitus ulcer in the sacral region. Laboratory investigations included the following: leukocyte count 15 530 k/µL, platelet count 142 000 k/µL, urea 141 mg/dL, sodium 174 mg/dL, chloride 124 mg/dL, albumin 2.0 g/dL, ALT 46 mg/dL, AST 128 mg/dL, LDH 610 mg/dL, CK 2598 mg/dL, total protein 5.2 mg/dL, sedimentation rate 46 mm/h and central venous pressure 0 cm/H2O. She demonstrated catatonic schizophrenia, prerenal acute kidney failure and hyperatraemia. Her condition improved with the administration of fluids, and she was transferred to the psychiatric clinic with a differential diagnosis of catatonic schizophrenia. A 27-year-old woman with motor mental retardation began receiving olanzapine due to increased restlessness
Data Loading...
