度洛西汀相关性后部可逆性脑病综合征：一例报告。
Duloxetine-related posterior reversible encephalopathy syndrome: A case report.
作者信息
Zappella Nathalie, Perier François, Pico Fernando, Palette Catherine, Muret Alexandre, Merceron Sybille, Girbovan Andrei, Marquion Fabien, Legriel Stephane
机构信息
Intensive Care Unit Neurology and Stroke Department Pharmacology Unit Emergency Department, Centre Hospitalier de Versailles - Site André Mignot, rue de Versailles, Le Chesnay cedex Paris Descartes University, Sorbonne Paris Cité-Medical School INSERM U970, Paris Cardiovascular Research Center, Paris, France.
出版信息
Medicine (Baltimore). 2016 Aug;95(33):e4556. doi: 10.1097/MD.0000000000004556.
BACKGROUND
Posterior reversible encephalopathy syndrome (PRES) has well-established links with several drugs. Whether a link also exists with serotonin-norepinephrine reuptake inhibitor such as duloxetine is unclear.
METHODS
We report on a patient who developed PRES with a coma and myoclonus related to hypertensive encephalopathy a few days after starting duloxetine treatment. Magnetic resonance imaging was performed and catecholamine metabolites assayed.
RESULTS
The patient achieved a full recovery after aggressive antihypertensive therapy and intravenous anticonvulsant therapy.
CONCLUSIONS
The clinical history, blood and urinary catecholamine and serotonin levels, and response to treatment strongly suggest that PRES was induced by duloxetine. Duloxetine should be added to the list of causes of PRES.
背景
后部可逆性脑病综合征（PRES）与多种药物之间存在明确关联。但5-羟色胺-去甲肾上腺素再摄取抑制剂（如度洛西汀）与PRES之间是否存在关联尚不清楚。
方法
我们报告了1例患者，该患者在开始度洛西汀治疗几天后出现与高血压脑病相关的昏迷和肌阵挛性PRES。进行了磁共振成像检查并测定了儿茶酚胺代谢产物。
结果
经过积极的抗高血压治疗和静脉注射抗惊厥治疗后，该患者完全康复。
结论
临床病史、血液和尿液中的儿茶酚胺及5-羟色胺水平以及对治疗的反应强烈提示，PRES是由度洛西汀诱发的。度洛西汀应被列入PRES的病因清单。
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