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The limited clinical utility of a routine creatine kinase (CK) on admission to a psychiatric inpatient unit.
BMC Psychiatry
December 2024
South London and Maudsley NHS Foundation Trust, London, UK.
Background: Creatine kinase (CK) is an intracellular enzyme expressed most commonly in tissues such as skeletal muscle. CK can be used as an investigation to support the diagnosis of conditions such as neuroleptic malignant syndrome (NMS), a rare idiosyncratic drug reaction - classically to antipsychotic medications - which can be fatal. Routine screening of CK in psychiatric inpatients is a known practice, but its value is uncertain.
View Article and Find Full Text PDFDiagnostic Challenges in Malignant Hyperthermia and Anesthesia-Induced Rhabdomyolysis: A Case Study.
Am J Case Rep
December 2024
Department of Surgery, Medical University of Sofia, University Hospital "Queen Giovanna - ISUL", Sofia, Bulgaria.
BACKGROUND Malignant hyperthermia (MH) and anesthesia-induced rhabdomyolysis (AIR) are rare, yet life-threatening complications that need prompt therapeutic actions and logistic preparedness for treatment success. Both conditions are triggered by general anesthetics, particularly volatiles and depolarizing muscle relaxants. In comparison with MH, which is an inherited pharmacogenomic disease of calcium channel receptor subpopulation and arises only after trigger exposure, AIR has been described mostly in patients with muscular dystrophies.
View Article and Find Full Text PDFInflammation-Related Non-Infectious Febrile Reaction Induced by Electroconvulsive Therapy in a Young Female with Bipolar Disorder: A Case Report and Literature Review.
Psychiatry Clin Psychopharmacol
November 2024
Department of Child and Adolescent Psychiatry, Kaohsiung Chang Gung Memorial, Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Article Synopsis
- Electroconvulsive therapy (ECT) is an effective treatment for persistent psychiatric disorders, though post-ECT fever is rare and not widely reported.
- A case study of a 27-year-old woman with bipolar disorder showed she experienced multiple fever episodes after ECT, with diagnostic tests indicating inflammation but no signs of infection or serious syndromes.
- The findings suggest that the fever may be a benign inflammatory response to ECT, allowing for the continued use of ECT to achieve therapeutic benefits.
Evaluating the adverse drug reactions to clozapine in populations of children and adolescents: insights from VigiBase data.
Eur Child Adolesc Psychiatry
December 2024
Mental Health Research Center, Eastern State Hospital, Lexington, KY, USA.
Article Synopsis
- Clozapine use is primarily associated with the risk of neutropenia, but there is limited research on adverse drug reactions (ADRs) and fatal outcomes in patients under 18 years old.
- A study analyzed 2,825 reports of clozapine usage in this age group, revealing 42 fatal outcomes, with the most common ADR being decreased white blood cell count, while suicide was a significant cause of non-duplicated fatalities.
- To better prevent fatal outcomes in young patients, child and adolescent psychiatrists should broaden their focus beyond severe neutropenia to include other serious ADRs like pneumonia, while still being cautious of the risk of overdose in those at risk for suicide.
Lamotrigine as a preventive agent against recurrent catatonia in adult-onset Niemann-Pick Type-C disease: a case report.
Neurocase
December 2024
Department of Psychiatry, Cerrahpaşa Faculty of Medicine, Istanbul University-Cerrahpaşa, Istanbul, Turkey.
Article Synopsis
- - Niemann-Pick Type-C (NPC) disease can lead to serious neuropsychiatric issues, including catatonia, which doesn't always respond well to standard treatments like antipsychotics.
- - A patient with adult-type NPC developed catatonia that persisted despite various medications, but improved significantly with electroconvulsive therapy (ECT).
- - Combining ECT with lorazepam managed the catatonia, and adding lamotrigine led to full remission for eight months, suggesting lamotrigine's potential benefits in treating recurrent catatonia.
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