Srifuengfung Maytinee, Sukakul Thanisorn, Liangcheep Chanika, Viravan Natee
Department of Psychiatry, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand.
Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand.
World J Clin Cases. 2020 Oct 26;8(20):4876-4882. doi: 10.12998/wjcc.v8.i20.4876.
Paliperidone palmitate is a once-monthly injectable, atypical antipsychotic. To our knowledge, there has been only one report of paliperidone palmitate-induced angioedema presenting with acute laryngeal edema with subsequent respiratory arrest. Here, we present a case report of paliperidone palmitate-induced angioedema with a relatively mild clinical presentation compared with the previously reported case, and the patient's condition was not complicated by life-threatening anaphylaxis.
A 79-year-old female, who had a major neurocognitive disorder due to Alzheimer's disease with behavioral disturbances. Paliperidone palmitate was off-label used to control her aggression, irritability, and psychosis. After induction doses (150 mg and 100 mg intramuscularly, given 1 wk apart), she developed intermittent swelling of the face, eyelids, and lips on day 17 after the initial dose, and the edema was explicitly seen on day 20. The diagnosis was paliperidone palmitate-induced angioedema. The monthly injection dose was discontinued on day 33 after the initial dose. The angioedema was subsequently alleviated, and it had completely resolved by day 40 after the initial dose.
Paliperidone palmitate-induced angioedema is a rare condition and can present with a mild, intermittent facial edema, which may be overlooked in clinical practice.
棕榈酸帕利哌酮是一种每月注射一次的非典型抗精神病药物。据我们所知，仅有一篇关于棕榈酸帕利哌酮诱发血管性水肿的报道，该病例表现为急性喉水肿并随后出现呼吸骤停。在此，我们报告一例棕榈酸帕利哌酮诱发血管性水肿的病例，与之前报道的病例相比，该病例临床表现相对较轻，且患者病情未并发危及生命的过敏反应。
一名79岁女性，患有因阿尔茨海默病所致的重度神经认知障碍并伴有行为障碍。棕榈酸帕利哌酮被用于超适应证治疗以控制她的攻击行为、易怒情绪及精神病症状。在给予诱导剂量（分别为150 mg和100 mg，肌内注射，间隔1周）后，她在首次给药后第17天出现面部、眼睑及唇部间歇性肿胀，并于第20天明显可见水肿。诊断为棕榈酸帕利哌酮诱发的血管性水肿。在首次给药后第33天停用每月注射剂量。血管性水肿随后缓解，并在首次给药后第40天完全消退。
棕榈酸帕利哌酮诱发的血管性水肿是一种罕见病症，可表现为轻度、间歇性面部水肿，在临床实践中可能被忽视。
