Mizumura Naoto, Uematsu Masato, Ito Aya, Okumura Satoshi, Maehira Hiromitsu, Ogawa Masao, Kawasaki Masayasu
Department of Surgery, Bellland General Hospital, Japan.
Postgraduate Education Center, Bellland General Hospital, Japan.
Intern Med. 2017 Nov 15;56(22):3089-3092. doi: 10.2169/internalmedicine.9037-17. Epub 2017 Sep 25.
Neuroleptic malignant syndrome (NMS) with characteristic symptoms is a potentially lethal reaction to antipsychotic drugs. Atypical NMS usually lacks major symptoms and frequently occurs after treatment using atypical antipsychotics, such as aripiprazole. A 64-year-old man developed aripiprazole-induced NMS after surgery, and our early recognition of the NMS was based on high creatine kinase levels and low serum iron levels. His characteristic symptoms (a fever, rigidity, and altered mental status) were only present for a few hours and were resolved by aripiprazole discontinuation and supportive care. Aripiprazole-induced NMS can present with brief but major symptoms, and clinicians may overlook this "brief" appearance of NMS.
具有特征性症状的神经阻滞剂恶性综合征(NMS)是对抗精神病药物的一种潜在致命反应。非典型NMS通常缺乏主要症状,且常发生于使用非典型抗精神病药物(如阿立哌唑)治疗后。一名64岁男性术后发生阿立哌唑所致的NMS,我们对NMS的早期识别基于高肌酸激酶水平和低血清铁水平。他的特征性症状(发热、强直和精神状态改变)仅出现了几个小时,通过停用阿立哌唑和支持性治疗得以缓解。阿立哌唑所致的NMS可能表现为短暂但严重的症状,临床医生可能会忽略NMS这种“短暂”的表现。