Karre Premnath Reddy, Gujral Jeetinder, Rodriguez Ernesto
North Shore/LIJ-Southside Hospital, Family Medicine Residency Program, Bay Shore, New York, 11706, USA.
BMJ Case Rep. 2009;2009. doi: 10.1136/bcr.06.2009.1931. Epub 2009 Aug 17.
A 56-year-old African American female with a history of schizophrenia developed rhabdomyolysis with creatine phosphokinase (CPK) levels of 5172 U/L after intramuscular injection of haloperidol decanoate. The patient was admitted to the hospital and treated with saline infusion alone. Serum CPK levels were decreased but not significantly so even after 4 days. Renal function tests and vital signs remained normal throughout her stay in the hospital. Urinary alkalinisation was done with sodium bicarbonate to maintain urine pH higher than 6.5 and the CPK levels declined gradually over the next 3 days. The patient was observed for 24 hours without saline infusion and urine alkalinisation but the serum CPK levels continued to increase and this regimen was restarted. The patient stayed in the hospital for 4 weeks on this regimen until the CPK levels decreased and remained normal. Our patient developed rhabdomyolysis without neuroleptic malignant syndrome.
一名56岁有精神分裂症病史的非裔美国女性，在肌肉注射癸酸氟哌啶醇后发生横纹肌溶解，肌酸磷酸激酶（CPK）水平达5172 U/L。患者入院后仅接受生理盐水输注治疗。血清CPK水平有所下降，但即便4天后仍未显著下降。在其住院期间，肾功能检查和生命体征一直正常。用碳酸氢钠进行尿液碱化以维持尿液pH高于6.5，在接下来的3天里CPK水平逐渐下降。在未进行生理盐水输注和尿液碱化的情况下对患者观察了24小时，但血清CPK水平持续升高，于是重新开始该治疗方案。患者在此治疗方案下住院4周，直至CPK水平下降并保持正常。我们的患者发生了横纹肌溶解，但未出现抗精神病药恶性综合征。
