[A case of neuroleptic malignant syndrome developed in liver cirrhosis patient addicted to alcohol].
A 55-year-old man with addiction of alcohol was admitted to our hospital with hematoemesis. After admission, the rupture of esophageal varices was observed and it was treated with endoscopic injection sclerotherapy. On the 3rd hospital day, the patient showed alcohol withdrawal syndrome and therefore haloperidol was administered intramuscularly and intravenously. After a half day of this treatment, high fever, diaphoresis, hypotension, tachycardia, muscular rigidity and tremor developed. With the laboratory data including high serum levels of CK, LDH, GOT and GPT, neuroleptic malignant syndrome (NMS) was suspected. Regardless of intensive care, hepatic failure, DIC and acute renal failure promptly developed, and he died on the 11th hospital day. Neuroleptics may cause serious side effects, such as NMS, when the physical status of patients was deteriorated. Especially in exhausted patient such as our case, even the small dose of neuroleptics caused NMS within short term. Thus, it seemed to be important for clinicians to pay attention to choice of neuroleptics.
Minamisawa
S
S
Second Department of Internal Medicine, Showa University School of Medicine.
Tezuka
T
T
Enomoto
K
K
Nozaki
Y
Y
Funatomi
H
H
Hatta
Y
Y
D000328:Adult; D000431:Ethanol / Q000009:adverse effects; D006220:Haloperidol / Q000009:adverse effects*; D006801:Humans; D008104:Liver Cirrhosis, Alcoholic / Q000150:complications*; D008297:Male; D009459:Neuroleptic Malignant Syndrome / Q000209:etiology*; D013375:Substance Withdrawal Syndrome / Q000150:complications
D000431:Ethanol; D006220:Haloperidol