Katta Natraj, Balla Sudarshan, Aggarwal Kul
Division of Cardiovascular Medicine - Department of Medicine - University of Missouri School of Medicine, Columbia/MO, USA .
Autops Case Rep. 2016 Dec 30;6(4):9-13. doi: 10.4322/acr.2016.054. eCollection 2016 Oct-Dec.
Hypersensitivity myocarditis is a rare but serious adverse effect of clozapine, a commonly used psychiatric drug. We report the case of sudden cardiac death from clozapine-induced hypersensitivity myocarditis diagnosed at autopsy. A 54-year-old Caucasian male on clozapine therapy for bipolar disorder presented with a sudden onset of shortness of breath. Laboratory studies were significant for elevated N-terminal prohormone of brain natriuretic peptide. During his hospital stay, the patient died of sudden cardiac arrest from ventricular tachycardia. The autopsy revealed hypersensitivity myocarditis, which usually occurs in the first 4 weeks after the initiation of clozapine. A 4-week monitoring protocol, including laboratory assessment of troponin and C-reactive protein, may assist in the early diagnosis of this potentially fatal condition.
超敏性心肌炎是常用精神科药物氯氮平一种罕见但严重的不良反应。我们报告一例尸检诊断为氯氮平诱导的超敏性心肌炎导致的心源性猝死病例。一名54岁接受氯氮平治疗双相情感障碍的白人男性突然出现呼吸急促。实验室检查显示脑钠肽前体N末端升高。住院期间，患者因室性心动过速导致的心搏骤停死亡。尸检发现超敏性心肌炎，通常发生在开始使用氯氮平后的前4周。一个为期4周的监测方案，包括对肌钙蛋白和C反应蛋白进行实验室评估，可能有助于早期诊断这种潜在致命疾病。
