Maempel Julian Fz, Darmanin Geraldine, Naeem Kashif, Patel Mehool
Department of Trauma and Orthopaedics, Frenchay Hospital, North Bristol National Health Service Trust, Bristol, UK.
Cases J. 2010 Jan 22;3:36. doi: 10.1186/1757-1626-3-36.
Venous thromboembolism is a very common pathological process for which there are many well known (and less well-known) predisposing factors. Likewise, olanzapine is a commonly used anti-psychotic medication.We present the case of a young Somali gentleman who developed venous thromboembolic disease after an overdose of olanzapine. The diagnosis was only made 48 hours after admission, due to the non-specific presentation of the pulmonary embolus and the fact that the link between olanzapine and pulmonary embolus was not previously widely described and therefore it did not immediately figure in the differential diagnosis. The patient made a full recovery.There is an increasing body of circumstantial evidence linking olanzapine to pulmonary embolus. Clinicians should bear this possible association in mind when prescribing the drug and when faced with clinical situations where venous thromboembolism (VTE) is a possible diagnosis. VTE has occasionally been described in therapeutic dose olanzapine therapy, but never in the context of an acute overdose. Khat, a recreational drug, has been linked to arterial, but not venous thrombosis.It is hoped that this case report will further encourage research into these associations, which remain to be proven and quantified.In the context of changing population demographics and increasing global migration, a greater awareness of the potential effects of endemic practices and their potential consequences is essential to the modern-day doctor working in a multi-cultural society.
静脉血栓栓塞是一种非常常见的病理过程，存在许多众所周知（以及不太知名）的诱发因素。同样，奥氮平是一种常用的抗精神病药物。我们报告了一例年轻的索马里男性病例，该患者在过量服用奥氮平后发生了静脉血栓栓塞性疾病。由于肺栓塞的表现不具有特异性，且奥氮平与肺栓塞之间的联系此前未被广泛描述，因此在入院48小时后才做出诊断，所以它没有立即出现在鉴别诊断中。患者完全康复。越来越多的间接证据将奥氮平与肺栓塞联系起来。临床医生在开这种药时以及面对可能诊断为静脉血栓栓塞（VTE）的临床情况时，应牢记这种可能的关联。VTE偶尔在奥氮平治疗剂量下被描述过，但从未在急性过量的情况下出现过。恰特草，一种消遣性药物，与动脉血栓形成有关，但与静脉血栓形成无关。希望本病例报告能进一步鼓励对这些关联进行研究，这些关联仍有待证实和量化。在人口结构不断变化和全球移民增加的背景下，提高对地方习俗的潜在影响及其潜在后果的认识，对于在多元文化社会中工作的现代医生至关重要。
