Matthews Christina J, Hall Tanya L
Psychiatry Registrar, Hunter New England Local Health District, The Mater Hospital, Waratah, NSW, Australia
Consultant Psychiatrist, Hunter New England Local Health District, The Mater Hospital, Waratah, NSW, Australia.
Australas Psychiatry. 2014 Dec;22(6):543-5. doi: 10.1177/1039856214559041. Epub 2014 Nov 11.
The following report presents a case in which significant clozapine toxicity was demonstrated in a patient on established therapy, in the absence of identifiable risk factors. Through this case report, the authors aim to highlight the potential for clozapine toxicity to occur unexpectedly in times of acute medical illness, and the need to remain vigilant in such situations.
Case report and review of the relevant literature.
We describe a case of a 62 year old man whom developed life-threatening clozapine toxicity in the context of a severe lower respiratory infection. Following investigation to exclude the usual causes of toxicity, it was surmised that impaired CYP1A2 function, secondary to the acute inflammatory process, had led to a toxic level of the drug.
Given the possibility that serum clozapine levels may significantly rise in acute illness, the team recommends measurement of clozapine levels in these situations, in combination with the usual full blood count investigation. Such a practice should be considered in the local monitoring protocol, to avoid incidence of potentially toxic outcomes.
以下报告介绍了一例病例，该病例中一名正在接受既定治疗的患者出现了显著的氯氮平毒性反应，且不存在可识别的风险因素。通过本病例报告，作者旨在强调在急性疾病期间氯氮平毒性可能意外发生的可能性，以及在此类情况下保持警惕的必要性。
病例报告及相关文献回顾。
我们描述了一例62岁男性病例，该患者在严重下呼吸道感染的情况下出现了危及生命的氯氮平毒性反应。在排除常见毒性原因的调查后，推测继发于急性炎症过程的CYP1A2功能受损导致了药物达到中毒水平。
鉴于急性疾病时血清氯氮平水平可能显著升高的可能性，研究团队建议在这些情况下测量氯氮平水平，并结合常规全血细胞计数检查。在当地监测方案中应考虑这种做法，以避免潜在毒性后果的发生。
