Bassi V, Fattoruso O, Santinelli C
1U.O.C di Medicina Generale e Lungodegenza.
U.O.C. di Patologia Generale Ospedale San Giovanni Bosco, ASL Na1-Centro, Naples, Italy.
Oxf Med Case Reports. 2019 Mar 29;2019(3):omz010. doi: 10.1093/omcr/omz010. eCollection 2019 Mar.
Syndrome of inappropriate antidiuretic hormone secretion (SIADH) is considered the prevalent cause of hyponatremia in hospitalized patients. Neuroleptic malign syndrome (NMS) is an idiosyncratic drug reaction showing fever, dysautonomia and rigidity with increased levels of Creatinine-phosphokinase (CPK) dependent on leakage of muscle contents into the circulation and defined as rhabdomyolysis. Although different diagnostic criteria for NMS have been established, it should be recognized that atypical presentations occur, particularly during treatment with atypical antipsychotics. We here present a case report of a psychiatric patient affected by a SIADH complicated with NMS/rhabdomyolysis, induced by second-generation (atypical) antipsychotic drugs in combination with carbamazepine and promazine.
抗利尿激素分泌不当综合征（SIADH）被认为是住院患者低钠血症的常见原因。抗精神病药物恶性综合征（NMS）是一种特异质性药物反应，表现为发热、自主神经功能障碍和强直，同时肌酸磷酸激酶（CPK）水平升高，这取决于肌肉成分漏入循环系统，并被定义为横纹肌溶解症。尽管已经确立了不同的NMS诊断标准，但应该认识到非典型表现是存在的，尤其是在使用非典型抗精神病药物治疗期间。我们在此报告一例精神病患者的病例，该患者受SIADH影响，并发NMS/横纹肌溶解症，由第二代（非典型）抗精神病药物联合卡马西平和丙嗪诱发。
