Yamada Haruhi, Katsumori Yukiko, Kawano Miki, Mori Shumpei, Takeshige Ryo, Mukai Jun, Imada Hiroshi, Shimoura Hiroyuki, Takahashi Hachidai, Horai Tadasu, Okita Yutaka, Hirata Ken-Ichi
Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Japan.
Department of Psychiatry, Kobe University Graduate School of Medicine, Japan.
Intern Med. 2018 Jun 15;57(12):1763-1767. doi: 10.2169/internalmedicine.0170-17. Epub 2018 Feb 9.
A 73-year-old man, with congestive heart failure due to combined valvar disease, underwent curative surgery. Although the surgery was successful, his clinical course was eventful because of pulmonary complications, and he began to deteriorate mentally. Quetiapine was prescribed, which appeared to effectively settle his mental status. Following the administration of quetiapine, however, he developed acute kidney injury (AKI) that required continuous hemodiafiltration. Subsequent to discontinuation of quetiapine, his renal function gradually improved. Atypical antipsychotic drugs, including quetiapine, are frequently used to treat delirium in elderly patients in the intensive-care setting. This case highlights a potential risk of quetiapine-related AKI.
一名73岁男性,因瓣膜病合并充血性心力衰竭接受了根治性手术。尽管手术成功,但由于肺部并发症,他的临床病程波折,且开始出现精神状态恶化。给予了喹硫平治疗,该药似乎有效稳定了他的精神状态。然而,在服用喹硫平后,他发生了急性肾损伤(AKI),需要持续进行血液透析滤过。停用喹硫平后,他的肾功能逐渐改善。包括喹硫平在内的非典型抗精神病药物常用于治疗重症监护病房老年患者的谵妄。该病例凸显了喹硫平相关急性肾损伤的潜在风险。