[Hemostatic evaluation of a patient with haloperidol-induced neuroleptic malignant syndrome associated with disseminated intravascular coagulation].
A 94-year-old man who had been admitted to our hospital for the treatment of senile dementia and restless behavior exhibited consciousness disturbances, acute respiratory failure, high fever, and thrombocytopenia the day after receiving haloperidol as prescribed by a psychiatrist. On the fourth day following administration of haloperidol, acute renal failure with rhabdomyolysis and disseminated intravascular coagulation (DIC) developed in the patient, who was accordingly given a diagnosis of haloperidol-induced neuroleptic malignant syndrome (NMS) associated with DIC. He was then given heparin and antithrombin III, and his DIC symptoms improved soon thereafter. Elevated plasma levels of tissue factor and tumor necrosis factor-alpha (TNF-alpha) were sustained during this therapy course. Other cytokines, including interleukin IL-1 beta, IL-2 and IL-6, were not elevated. There are activation of extrinsic coagulation and an elevated level of TNF-alpha during acute renal failure and rhabdomyolysis associated with NMS, which is thought to trigger the onset of DIC.
Seki
Y
Y
First Department of Internal Medicine, Niigata University School of Medicine.
Takahashi
H
H
Aizawa
Y
Y
D058186:Acute Kidney Injury / Q000097:blood / Q000139:chemically induced; D000368:Aged; D000369:Aged, 80 and over; D014150:Antipsychotic Agents / Q000009:adverse effects*; D001777:Blood Coagulation; D001779:Blood Coagulation Factors / Q000378:metabolism; D004211:Disseminated Intravascular Coagulation / Q000097:blood / Q000139:chemically induced*; D006220:Haloperidol / Q000009:adverse effects*; D006801:Humans; D008297:Male; D009459:Neuroleptic Malignant Syndrome / Q000097:blood / Q000209:etiology*; D012206:Rhabdomyolysis / Q000097:blood / Q000139:chemically induced; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism
D014150:Antipsychotic Agents; D001779:Blood Coagulation Factors; D014409:Tumor Necrosis Factor-alpha; D006220:Haloperidol