Elyasi Forouzan, Zarghami Mehran, Fariborzifar Arghavan, Cheraghmakani Hamed, Shirzad Mahboobeh, Kazempour Feteme
Sexual and Reproductive Health Research Center, Psychiatry and Behavioral Sciences Research Center Addiction Institute, Mazandaran University of Medical Sciences Sari Iran.
Department of Psychiatry, Faculty of Medicine Mazandaran University of Medical Sciences Sari Iran.
Clin Case Rep. 2023 Aug 2;11(8):e7734. doi: 10.1002/ccr3.7734. eCollection 2023 Aug.
In some patients, neuroleptic malignant syndrome is accompanied significant high levels of erythrocyte sedimentation rate (ESR), C-reactive protein (CRP).
Neuroleptic malignant syndrome (NMS) is an idiosyncratic life-threatening adverse reaction and usually triggered in response to antipsychotic drugs. In addition, leukocytosis and increased muscle enzymes levels (especially creatine phosphokinase) are observed in NMS. In addition, a transient increase in different types of acute phase reactants in NMS has been mentioned. This article describes a woman treated with haloperidol, perphenazine, escitalopram, and alprazolam because she developed catatonic symptoms after psychological stress. She suffered from NMS symptoms and had elevated CRP and ESR levels, among other signs and symptoms. Given the COVID-19 pandemic and reports of co-occurrence of catatonia and NMS and COVID-19 and elevated erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP), this patient was a diagnostic dilemma. After consultation with the consultation-liaison psychiatry units, she was managed adequately with electroconvulsive therapy and lorazepam.
在一些患者中，抗精神病药恶性综合征伴有显著高水平的红细胞沉降率（ESR）和C反应蛋白（CRP）。
抗精神病药恶性综合征（NMS）是一种特异质性的、危及生命的不良反应，通常由抗精神病药物诱发。此外，在NMS中还观察到白细胞增多和肌肉酶水平升高（尤其是肌酸磷酸激酶）。另外，有提到NMS中不同类型急性期反应物会短暂增加。本文描述了一名女性患者，她在心理应激后出现紧张症症状，接受了氟哌啶醇、奋乃静、艾司西酞普兰和阿普唑仑治疗。她出现了NMS症状，除其他体征和症状外，还伴有CRP和ESR水平升高。鉴于新冠疫情以及紧张症和NMS与新冠病毒同时出现且红细胞沉降率（ESR）和C反应蛋白（CRP）升高的报道，该患者的诊断陷入困境。在与会诊联络精神科会诊后，她通过电休克治疗和劳拉西泮得到了妥善处理。
