Chen Liming, Tan Pei, Tan Xiaolin
Chongqing Mental Health Center, Chongqing, China.
Shanghai Arch Psychiatry. 2015 Dec 25;27(6):374-7. doi: 10.3969/j.issn.1002-0829.215005.
An increase in the concentration of eosinophils in blood may lead to endocarditis, myocarditis, and pericarditis. When the absolute eosinophil count increases beyond 1.5 x 10(9)/L, myocardial damage and even death can occur. This case report describes a 47-year-old male with an alcohol-induced psychotic disorder who developed eosinophilia 4 weeks after starting treatment with quetiapine 50-200 mg/d. His maximum recorded absolute eosinophil count was 7.63 x 10(9)/L (normal range < 0.5 x 10(9)/L), but the level returned to normal over a 4-week period after stopping quetiapine and no myocardial damage was observed. This patient's dramatic eosinophilia did not have any associated clinical symptoms; it was only identified as part of a routine blood test a few weeks after starting quetiapine. This is a reminder that all clinicians who treat patients with antipsychotic medications must be vigilant about the occurrence of such rare but life-threatening adverse events.
血液中嗜酸性粒细胞浓度增加可能导致心内膜炎、心肌炎和心包炎。当绝对嗜酸性粒细胞计数超过1.5×10⁹/L时，可能会发生心肌损伤甚至死亡。本病例报告描述了一名47岁患有酒精性精神障碍的男性，在开始使用50 - 200mg/d喹硫平治疗4周后出现嗜酸性粒细胞增多。他记录到的最高绝对嗜酸性粒细胞计数为7.63×10⁹/L（正常范围<0.5×10⁹/L），但在停用喹硫平后的4周内该水平恢复正常，且未观察到心肌损伤。该患者显著的嗜酸性粒细胞增多未伴有任何临床症状；只是在开始使用喹硫平几周后的一次常规血液检查中才被发现。这提醒所有使用抗精神病药物治疗患者的临床医生，必须警惕此类罕见但危及生命的不良事件的发生。
