[Malignant neuroleptic syndrome: complete anticoagulant treatment or not?].
A case is reported, in which fatal pulmonary embolism complicated the course of a neuroleptic malignant syndrome (NMS). This syndrome includes several risk factors for the development of venous thromboembolism, such as: protracted immobility; severe rigidity causing a slowing of blood flow through the deep venous system; hypovolaemia with increased blood viscosity and activation of coagulation by rhabdomyolysis. An analysis of 115 case reports in the literature on NMS showed that 3 out of 13 patients with fatal NMS (23%) died of pulmonary embolism. The reviewed case, the literature findings and the risk factors mentioned cause us to believe that complete anticoagulant therapy may have a place in the therapeutic approach to patients with NMS.
van Agtmael
M A
MA
St. Elisabeth Hospitaal, afd. Interne Geneeskunde, Willemstad, Curaçao, Nederlandse Antillen.
van Harten
P N
PN
D000328:Adult; D000925:Anticoagulants / Q000627:therapeutic use*; D001712:Biperiden / Q000009:adverse effects; D003866:Depressive Disorder / Q000188:drug therapy*; D004359:Drug Therapy, Combination; D006220:Haloperidol / Q000009:adverse effects; D006801:Humans; D008297:Male; D009459:Neuroleptic Malignant Syndrome / Q000188:drug therapy*; D011183:Postoperative Complications / Q000188:drug therapy; D011655:Pulmonary Embolism / Q000517:prevention & control*
D000925:Anticoagulants; D001712:Biperiden; D006220:Haloperidol
Het maligne neurolepticasyndroom: wel of geen volledige antistollingsbehandeling?