Arora Bhawana, Kannikeswaran Nirupama
Department of Pediatric Emergency Medicine, Children's Hospital of Michigan, Detroit Medical Center, 3901 Beaubien Street, Detroit, MI 48201 USA.
Int J Emerg Med. 2010 Aug 20;3(4):373-7. doi: 10.1007/s12245-010-0195-7.
Serotonin syndrome is a potentially life-threatening adverse drug reaction that results from therapeutic drug use, usually of selective serotonin reuptake inhibitors (SSRIs), intentional excessive use or interactions between various drugs.
A 16-year-old Caucasian boy presented to our emergency department (ED) with alteration in his mental status for 6 h prior to arrival. On physical examination in our ED, he was combative and disoriented to time, place and person. He was febrile, hypertensive and tachycardic as well. He had intermittent rigid extremities with myoclonus of both lower extremities. A diagnosis of serotonin syndrome (SS) was made based on history of intake of fluoxetine and clinical signs, which included presence of inducible clonus and agitation. The child received supportive care involving intravenous fluids and intravenous lorazepam. The child was back to his baseline mental status and had a normal neurological exam by 24 h and was discharged home later for follow-up with a psychiatrist.
SS occurs with increasing frequency, and most cases resolve with prompt recognition and supportive care. Failure to make an early diagnosis and to comprehend adverse pharmacological effects of therapy can lead to adverse outcomes.
血清素综合征是一种潜在的危及生命的药物不良反应，由治疗性药物使用引起，通常是选择性血清素再摄取抑制剂（SSRI），故意过量使用或多种药物之间的相互作用。
一名16岁的白人男孩在到达前6小时因精神状态改变被送往我们的急诊科（ED）。在我们急诊科进行体格检查时，他好斗，对时间、地点和人物定向障碍。他还发热、高血压和心动过速。他有间歇性四肢僵硬，双下肢有肌阵挛。根据氟西汀摄入史和临床体征，包括可诱导的阵挛和激动，诊断为血清素综合征（SS）。该患儿接受了包括静脉输液和静脉注射劳拉西泮在内的支持治疗。患儿在24小时后恢复到基线精神状态，神经系统检查正常，随后出院回家，由精神科医生进行随访。
血清素综合征的发生率越来越高，大多数病例通过及时识别和支持治疗得以解决。未能早期诊断并理解治疗的不良药理作用可能导致不良后果。
