Plasmapheresis for a schizophrenic patient with drug-induced lupus anti-coagulant.
A 59-year-old patient with schizophrenia developed Sjögren's syndrome. She also presented with the lupus anticoagulant attributed to long-term medication with chlorpromazine. Serial plasmapheresis treatments were performed to decrease the anti-coagulant activity. As a result, the activated partial thromboplastin time was temporarily improved, but the lupus anti-coagulant activity did not change. Because of her unstable emotional state, she continued to require chlorpromazine, but took a low dose of aspirin (87 mg/day) and never manifested any signs of thrombotic events. In view of the potential anti-thrombotic effects of chlorpromazine, it may not be necessary to use plasmapheresis in an attempt to reduce anti-coagulant activity among patients with chlorpromazine-induced lupus anti-coagulant.
Matsukawa
Y
Y
First Department of Internal Medicine, Nihon University School of Medicine, Tokyo, Japan.
Satoh
M
M
Itoh
T
T
Nishinarita
S
S
Horie
T
T
Abe
K
K
Takahashi
A
A
Kojima
T
T
D014150:Antipsychotic Agents / Q000009:adverse effects; D001241:Aspirin / Q000008:administration & dosage; D002746:Chlorpromazine / Q000009:adverse effects; D005260:Female; D006801:Humans; D016682:Lupus Coagulation Inhibitor / Q000097:blood*; D008875:Middle Aged; D010314:Partial Thromboplastin Time; D010956:Plasmapheresis; D012559:Schizophrenia / Q000097:blood / Q000150:complications* / Q000188:drug therapy; D012859:Sjogren's Syndrome / Q000097:blood / Q000139:chemically induced* / Q000628:therapy*; D013927:Thrombosis / Q000517:prevention & control
D014150:Antipsychotic Agents; D016682:Lupus Coagulation Inhibitor; D001241:Aspirin; D002746:Chlorpromazine