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双相情感障碍年轻女性患者电休克治疗诱发的炎症相关非感染性发热反应:一例报告及文献复习

Inflammation-Related Non-Infectious Febrile Reaction Induced by Electroconvulsive Therapy in a Young Female with Bipolar Disorder: A Case Report and Literature Review.

作者信息

Lin Chia-Chi, Chiu Nien-Mu, Lee Yu, Wang Liang-Jen

机构信息

Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang, Gung University College of Medicine, Kaohsiung, Taiwan.

Department of Child and Adolescent Psychiatry, Kaohsiung Chang Gung Memorial, Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.

出版信息

Psychiatry Clin Psychopharmacol. 2024 Nov 28;34(4):349-352. doi: 10.5152/pcp.2024.24922.

Abstract

Electroconvulsive therapy (ECT) has been employed as an effective treatment for refractory psychiatric disorders worldwide. Despite its extensive use, the occurrence of a fever following ECT has been rare and seldom documented. The reasons behind a post-ECT fever could vary; instances solely attributed to inflammation have been scarcely reported. We present the case of a 27-year-old woman diagnosed with bipolar disorder who experienced multiple fever episodes after having ECT. Diagnostic tests revealed elevated C-reactive protein (CRP) levels with no other infectious focus or possibility of neuroleptic malignant syndrome. We propose that this febrile reaction without real infection was related to inflammatory response triggered by ECT, with the release of various neurotransmitters into the brain and changes in the microsystems. Under this impression, we can speculate that it is a benign and reversible process, allowing us to continue ECT and achieve therapeutic efficacy. This might be the first report to suggest that an ECT-induced fever is related to inflammatory reactions.

摘要

在全球范围内,电休克疗法(ECT)已被用作治疗难治性精神疾病的有效方法。尽管其应用广泛,但ECT后出现发热的情况却很罕见,且鲜有文献记载。ECT后发热的原因可能多种多样;仅归因于炎症的情况几乎没有报道。我们报告了一例27岁被诊断为双相情感障碍的女性患者,她在接受ECT后出现了多次发热发作。诊断测试显示C反应蛋白(CRP)水平升高,没有其他感染病灶,也不存在抗精神病药物恶性综合征的可能性。我们认为这种无实际感染的发热反应与ECT引发的炎症反应有关,各种神经递质释放到大脑中以及微系统发生变化。基于这种认识,我们可以推测这是一个良性且可逆的过程,使我们能够继续进行ECT并实现治疗效果。这可能是第一份表明ECT诱发的发热与炎症反应有关的报告。

相似文献

本文引用的文献

1
Post-Electroconvulsive Therapy Hyperthermia: A Case Report.
J ECT. 2021 Dec 1;37(4):e37-e38. doi: 10.1097/YCT.0000000000000784.
2
Fever as a Side Effect after Electroconvulsive Therapy.电抽搐治疗后的副作用之一:发热。
Neuropsychobiology. 2022;81(1):19-27. doi: 10.1159/000511542. Epub 2021 Jul 7.
3
Role of C-Reactive Protein at Sites of Inflammation and Infection.C-反应蛋白在炎症和感染部位的作用。
Front Immunol. 2018 Apr 13;9:754. doi: 10.3389/fimmu.2018.00754. eCollection 2018.
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Post-Electroconvulsive Therapy Hyperthermia: Case Report.电休克治疗后高热:病例报告
J ECT. 2017 Sep;33(3):e24-e25. doi: 10.1097/YCT.0000000000000394.
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Adverse Effects of Electroconvulsive Therapy.电休克治疗的不良反应
Psychiatr Clin North Am. 2016 Sep;39(3):513-30. doi: 10.1016/j.psc.2016.04.004. Epub 2016 Jun 25.
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Drug fever caused by propofol in the intensive care unit.重症监护病房中丙泊酚引起的药物热。
J Anesth. 2015 Oct;29(5):786-9. doi: 10.1007/s00540-015-2007-y. Epub 2015 Mar 24.
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Catheter-related bloodstream infections.导管相关血流感染
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Post-ECT hyperthermia and rapid mood improvements: a case report.
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