Sema UÇAK BASAT, Ridvan SİVRİTEPE, Damla ORTABOZ, Ecem SEVİM

Şizofrenik Bir Erişkinde Olanzapine Bağlı Rabdomiyoliz: Olgu Sunumu

Rabdomiyoliz iskelet kasının akut nekrozu ve hücre içeriğinin dolaşıma geçmesi ile karakterize bir sendromdur. Travma, egzersiz, enfeksiyonlar ve bazı metabolik hastalıklara bağlı ortaya çıkabildiği gibi çeşitli ilaç kullanımlarına sekonder de görülebilen bir durumdur. Bilinen 2 aydır şizofreni tanısı olan 34 yaşındaki erkek hasta acil servisimize suicid amaçlı toplamda 350 mg Olanzapin alımı nedeniyle yakınları tarafından getirilmiş. Yapılan değerlendirilmesinde ekstrapiramidal sistem bulguları mevcut olan ve laboratuvar tetkiklerinde kreatin kinaz (CK) düzeyi 42670 U/L saptanan hasta olanzapin kullanımına sekonder rabdomiyoliz nedeniyle servisimize interne edildi. Yattığı süre içerisinde sadece medikal tedaviyle CK düzeyi normale dönen ve böbrek ve karaciğer fonksiyon bozukluğu gelişmeyen hasta psikiyatri poliklinik kontrolü önerilerek taburcu edildi. Rabdomiyoliz antipsikotik ilaçlara karşı nadir ve potansiyel olarak ciddi bir advers ilaç reaksiyonudur. Vakamızda olduğu gibi yüksek doz atipik antipsikotik ilaç alımlarından sonra hastalar mutlaka rabdomyoliz ve buna bağlı akut böbrek hasarı gibi ciddi komplikasyonlar açısından takip edilmelidir.

Anahtar Kelimeler:

Olanzapin, Rabdomiyoliz, Suisid

Olanzapine Induced Rhabdomyolysis in A Schizophrenic Adult: Case Report

Rhabdomyolysis is a syndrome characterized by acute necrosis of skeletal muscle and subsequent release of its cellular contents into the circulation. It can occur due to trauma, exercise, infections and some metabolic diseases, as well as secondary to the use of various drugs. A 34-year-old male patient with a diagnosis of schizophrenia for 2 months was brought to our emergency department by his relatives because of the intake of 350 mg of olanzapine for suicide. The patient whose extrapyramidal system findings were present and whose creatine kinase (CK) was found to be 42670 U / L in laboratory tests was hospitalized to our service because of the secondary rhabdomyolysis for the use of olanzapine. During the hospitalization period, only the medical treatment returned normalcy to the CK level, and the kidney and liver dysfunction did not develop, and the patient was discharged by psychiatric outpatient clinic control. Rhabdomyolysis is a rare and potentially serious adverse drug reaction to antipsychotic drugs. The patients should be evaluated for side effects and in terms of rhabdomyolysis facilitating factors. Especially in high doses, patients should be monitored for rhabdomyolysis, which is a serious complication, such as acute renal damage.

Keywords:

Olanzapine, Rhabdomyolysis, Suicide,

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