These tools will no longer be maintained as of December 31, 2024. Archived website can be found here. PubMed4Hh GitHub repository can be found here. Contact NLM Customer Service if you have questions.


Pubmed for Handhelds

PUBMED FOR HANDHELDS

Search MEDLINE/PubMed

  • Title: [Neuroleptic malignant syndrome. A case report].
    Author: Guadagnucci A, Tornaboni D, Vignali G, Mariotti M, Cincinelli A, Vignale L.
    Journal: Minerva Med; 1995; 86(7-8):327-30. PubMed ID: 7478078.
    Abstract:
    A lethal case of neuroleptic malignant syndrome in a 42-year-old woman with a history of bipolar psychiatric disorder under treatment with haloperidol is reported. The patient, hospitalized many times in the past for psychiatric treatment, was then admitted for treatment of a relapse of the disease during a exceedingly hot period. The patient complained of hallucinations and stomach ache. It was necessary to increase the dose of haloperidol to 2 mg, 3 times a day, and to give a single dose of perphenazine enanthate 100 mg. All tests proved normal except for CPK 274 U/l and urea 14 mg/dl. On hospital day 2, went into coma with high temperature, diaphoresis, polyuria, leucocytosis (WBC count 15,440 U/mm3), urea 7 mg/dl, LDH 425 U/l, Na 114 mEq/l, K 2.5 mEq/l. The rapid improvement following hypertonic saline treatment encouraged a diagnosis of water intoxication. On hospital day 7, continuing with the haloperidol treatment, the patient developed a high temperature and deterioration torpor. On hospital day 9, the patient went back into coma with temperature over 40 degrees C (104 degrees F), with fine myoclonia most visible on the face, and muscular rigidity. The CPK, rose from 5,169 to 28,060 U/l in less than 24 hours; the serum myoglobin rose to 41,000 ug/l. On day hospital 11 developed renal, cardiac and respiratory insufficiency. The picture deteriorated and dantrolene was no longer of use in controlling the fever. Then with a fever of over 42 degrees (108 degrees F) and the CPK at 50,000 the patient died. The autopsy demonstrated widespread rhabdomyolysis, a picture of widespread aspecific shock in all organs and picture of myoglobin-induced tabular necrosis of the kidney.
    [Abstract] [Full Text] [Related] [New Search]