Faculty of Medicine, University of Khartoum, PO Box 201, Khartoum, Sudan.
Caludon Centre, Clifford Bridge Road, Coventry, CV2 2TE, UK.
J Med Case Rep. 2024 Apr 18;18(1):190. doi: 10.1186/s13256-024-04508-0.
Significant elevation of creatine kinase levels (above three digits) and leucocytosis in the absence of muscle rigidity, tremors, or autonomic dysfunction can pose a real challenge in the context of antipsychotic treatment as an early herald of neuroleptic malignant syndrome.
We present here two cases of adult male patients of Black British heritage, ages 51 years and 28 years, respectively. Both received a diagnosis of schizoaffective disorder and presented with massive increase of creatine kinase blood level after aripiprazole depot administration, one with pernicious increase associated with silent neuroleptic malignant syndrome, and the second with asymptomatic benign enzyme elevation.
Though aripiprazole use is less likely to cause neuroleptic malignant syndrome, on rare occasions it can produce massive symptomatic or asymptomatic increase in serum creatine kinase enzyme levels, raising the need for close monitoring, especially at the initial doses of the drug.
在没有肌肉僵硬、震颤或自主神经功能障碍的情况下，肌酸激酶水平（高于三位数）和白细胞增多显著升高，这在抗精神病药物治疗中确实是一个挑战，可能是神经阻滞剂恶性综合征的早期先兆。
我们在此介绍两例成年男性黑人患者，年龄分别为 51 岁和 28 岁。两人均被诊断为分裂情感障碍，并在使用阿立哌唑长效注射剂后出现肌酸激酶血水平显著升高，一例伴有无症状神经阻滞剂恶性综合征的严重升高，另一例则为无症状良性酶升高。
尽管阿立哌唑的使用不太可能导致神经阻滞剂恶性综合征，但在极少数情况下，它会导致血清肌酸激酶酶水平显著升高，出现症状或无症状，因此需要密切监测，尤其是在药物初始剂量时。
