title: Neuroleptic malignant syndrome after haloperidol and fentanyl infusion in a patient with cancer with severe mineral imbalance.
abstract: This case report describes a terminally ill patient with cancer with severe hypophosphataemia, hypocalcemia, and hypomagnesemia who developed neuroleptic malignant syndrome after administration of a combination of haloperidol and fentanyl. The chief etiology of neuroleptic malignant syndrome in this patient was administration of haloperidol, but fentanyl and coexisting mineral imbalance could have contributed to development of the syndrome. Palliative care clinicians should be aware that neuroleptic malignant syndrome can occur in their patients receiving haloperidol.
authors.affiliation: Palliative Care Team and Seirei Hospice, Seirei Mikatabara Hospital, Hamamatsu, Shizuoka, Japan. seireihc@jt6.so-net.ne.jp
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Morita
authors.forename: Hideki
authors.initials: H
authors.lastname: Shishido
authors.forename: Yo
authors.initials: Y
authors.lastname: Tei
authors.forename: Satoshi
authors.initials: S
authors.lastname: Inoue
authors.forename: Kenji
authors.initials: K
authors.lastname: Nagayama
mesh_terms: D000368:Aged; D000701:Analgesics, Opioid / Q000009:adverse effects* / Q000627:therapeutic use; D018492:Dopamine Antagonists / Q000009:adverse effects* / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D004938:Esophageal Neoplasms / Q000150:complications*; D005283:Fentanyl / Q000009:adverse effects* / Q000378:metabolism / Q000627:therapeutic use; D006220:Haloperidol / Q000009:adverse effects* / Q000378:metabolism / Q000627:therapeutic use; D006801:Humans; D006996:Hypocalcemia / Q000150:complications / Q000378:metabolism; D017674:Hypophosphatemia / Q000150:complications / Q000378:metabolism; D008297:Male; D009459:Neuroleptic Malignant Syndrome / Q000175:diagnosis* / Q000209:etiology; D010166:Palliative Care / Q000379:methods*
chemical_list: D000701:Analgesics, Opioid; D018492:Dopamine Antagonists; D006220:Haloperidol; D005283:Fentanyl