Ratnam Caroline, Saguin Emeric, Keou Symphonie, Plantamura Julie, Mennessier Coralie, Lahutte Bertrand, Delacour Hervé
Département des laboratoires, Hôpital d'instruction des armées Bégin, Saint Mandé, France.
Service de psychiatrie, Hôpital d'instruction des armées Bégin, Saint Mandé, France.
Ann Biol Clin (Paris). 2018 Jun 1;76(3):329-335. doi: 10.1684/abc.2018.1351.
We report the case of a 40-year-old patient followed for post-traumatic stress disorder. A re-evaluation of its pharmacological treatment with the introduction of mirtazapine (30 mg/day) was associated with a rhabdomyolysis (CK> 20,000 IU/L at day 3). The diagnosis of mirtazapine induced rhabdomyolysis was made. After withdrawal of this drug combined with a symptomatic treatment (hydratation), the patient recovered well and was discharged without any nephrological sequelae. This article is intended to underline the diagnostic approach to elevated CK activity and the potential role of the "medical biologist" as a consultant for the relevant use of biological examinations. A physiopathological mechanism of this rhabdomyolysis is also proposed.
我们报告了一例40岁患有创伤后应激障碍的患者。重新评估其药物治疗并引入米氮平（30毫克/天）后，患者出现了横纹肌溶解（第3天时肌酸激酶>20,000 IU/L）。诊断为米氮平诱发的横纹肌溶解。停用该药物并进行对症治疗（补液）后，患者恢复良好，出院时无任何肾脏后遗症。本文旨在强调对肌酸激酶活性升高的诊断方法以及“医学生物学家”作为生物检查合理使用顾问的潜在作用。还提出了这种横纹肌溶解的病理生理机制。
