| 摘要 |
Neuroleptic malignant syndrome (NMS) is an uncommon and unpredictable complication of neuroleptic therapy which is characterized by hyperthermia, rigidity, altered mentation and autonomic instability. This complication is potentially lethal, with a mortality rate of 15 to 25%. However, the etiology of NMS and its pathophysiologic mechanisms remain uncertain. Many medical complications have been reported in conjunction with NMS, including myocardial infarction, leukoencephalopathy, acute renal failure, fulminant liver failure, thrombocytopenia, compartment syndrome and massive intestinal bleeding. However, only one case with NMS complicated with ischemic colitis has been reported. We report a patient with schizophrenia initially diagnosed at 34 years old who took olanzapine for about 2 years and developed NMS. In addition to the typical symptoms and signs of NMS, small bowel ischemic necrosis requiring surgical intervention occurred during the episode. We describe the clinical course, the management and the possible mechanism in this patient. This case indicates that NMS can be complicated by acute mesenteric ischemia and the need for awareness of this rare complication. |
