Olanzapine-Induced Diabetic Ketoacidosis and Neuroleptic Malignant Syndrome with Rhabdomyolysis: A Case Report
사영경, 양현, 정희경, 손장원, 이성수, 김성래, 유순집, Cha Bong-Yeon, Son Ha-Young, 배지은,
소속 상세정보
사영경 ( Sa Young-Kyoung )
Catholic University College of Medicine Bucheon St. Mary’s Hospital Department of Internal Medicine
양현 ( Yang Hyeon )
Catholic University College of Medicine Bucheon St. Mary’s Hospital Department of Internal Medicine
정희경 ( Jung Hee-Kyoung )
Catholic University College of Medicine Bucheon St. Mary’s Hospital Department of Internal Medicine
손장원 ( Son Jang-Won )
Catholic University College of Medicine Bucheon St. Mary’s Hospital Department of Internal Medicine
이성수 ( Lee Seong-Su )
Catholic University College of Medicine Bucheon St. Mary’s Hospital Department of Internal Medicine
김성래 ( Kim Seong-Rae )
Catholic University College of Medicine Bucheon St. Mary’s Hospital Department of Internal Medicine
유순집 ( Yoo Soon-Jib )
Catholic University College of Medicine Bucheon St. Mary’s Hospital Department of Internal Medicine
( Cha Bong-Yeon )
Catholic University College of Medicine Seoul St. Mary’s Hospital Department of Internal Medicine
( Son Ha-Young )
Catholic University College of Medicine Seoul St. Mary’s Hospital Department of Internal Medicine
배지은 ( Pae Chi-Un )
Catholic University College of Medicine Bucheon St. Mary’s Hospital Department of Psychiatry
KMID : 0356620130280010070
Abstract
Atypical antipsychotics have replaced conventional antipsychotics in the treatment of schizophrenia because they have less of a propensity to cause undesirable neurologic adverse events including extrapyramidal symptoms, tardive dyskinesia, and neuroleptic malignant syndrome (NMS). However, atypical antipsychotics have been known to result in various metabolic complications such as impaired glucose tolerance, diabetes and even diabetic ketoacidosis (DKA). In addition, a number of NMS cases have been reported in patients treated with atypical antipsychotics, although the absolute incidence of neurologic side effects is currently significantly low. Here, we report a patient who simultaneously developed DKA, acute renal failure and NMS with rhabdomyolysis after olanzapine treatment. Olanzapine-induced metabolic complications and NMS were dramatically improved with cessation of the olanzapine treatment and initiation of supportive management including fluid therapy, hemodialysis, and intensive glycemic control using insulin. At short-term follow-up, insulin secretion was markedly recovered as evidenced by a restoration of serum C-peptide level, and the patient no longer required any hypoglycemic medications. Despite the dramatic increase in the use of atypical antipsychotics treatment, individualized treatments along with careful monitoring may be prudent for high risk or vulnerable patients in order to avoid the development of metabolic side effects.
키워드
Diabetic ketoacidosis;Neuroleptic malignant syndrome;Olanzapine
원문 및 링크아웃 정보
등재저널 정보