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Marouane B, El Kadiri S, Merbouh M, El Aidouni G, Bkiyar H, Housni B. Acute alithiasic pancreatitis following the use of Risperidone in a young man with schizophrenia: As a rare case report. Radiol Case Rep 2023; 18:2434-2436. [PMID: 37275744 PMCID: PMC10232941 DOI: 10.1016/j.radcr.2023.04.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Accepted: 04/13/2023] [Indexed: 06/07/2023] Open
Abstract
Acute pancreatitis due to antipsychotic treatment is a rare but serious complication. Risperidone is among the rarest atypical antipsychotics associated with acute pancreatitis. Here, we report the case of acute pancreatitis developing 2 years after the use of Risperidone in a young man with schizophrenia. The mechanism and the time of occurrence in this case are at odds with what is generally reported in the literature.
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Affiliation(s)
- Boukroute Marouane
- Faculty of Medicine and Pharmacy, Mohammed First University Oujda, Hay Al Irfane, Rue Errazi, N 51, Oujda 60000, Morocco
- Intensive Care Unit, Mohammed VI University Hospital Center, Oujda, Morocco
- Anesthesiology and Intensive Care Unit Department, Mohammed First University, Faculty of Medicine and Pharmacy, Oujda, Morocco
| | - Soufyane El Kadiri
- Faculty of Medicine and Pharmacy, Mohammed First University Oujda, Hay Al Irfane, Rue Errazi, N 51, Oujda 60000, Morocco
- Intensive Care Unit, Mohammed VI University Hospital Center, Oujda, Morocco
- Anesthesiology and Intensive Care Unit Department, Mohammed First University, Faculty of Medicine and Pharmacy, Oujda, Morocco
| | - Manal Merbouh
- Faculty of Medicine and Pharmacy, Mohammed First University Oujda, Hay Al Irfane, Rue Errazi, N 51, Oujda 60000, Morocco
- Intensive Care Unit, Mohammed VI University Hospital Center, Oujda, Morocco
- Mohammed First University Oujda, FMP Oujda, LAMCESM, Oujda, Morocco
- Anesthesiology and Intensive Care Unit Department, Mohammed First University, Faculty of Medicine and Pharmacy, Oujda, Morocco
| | - Ghizlane El Aidouni
- Faculty of Medicine and Pharmacy, Mohammed First University Oujda, Hay Al Irfane, Rue Errazi, N 51, Oujda 60000, Morocco
- Intensive Care Unit, Mohammed VI University Hospital Center, Oujda, Morocco
- Mohammed First University Oujda, FMP Oujda, LAMCESM, Oujda, Morocco
- Anesthesiology and Intensive Care Unit Department, Mohammed First University, Faculty of Medicine and Pharmacy, Oujda, Morocco
| | - Houssam Bkiyar
- Faculty of Medicine and Pharmacy, Mohammed First University Oujda, Hay Al Irfane, Rue Errazi, N 51, Oujda 60000, Morocco
- Intensive Care Unit, Mohammed VI University Hospital Center, Oujda, Morocco
- Mohammed First University Oujda, FMP Oujda, LAMCESM, Oujda, Morocco
- Anesthesiology and Intensive Care Unit Department, Mohammed First University, Faculty of Medicine and Pharmacy, Oujda, Morocco
| | - Brahim Housni
- Faculty of Medicine and Pharmacy, Mohammed First University Oujda, Hay Al Irfane, Rue Errazi, N 51, Oujda 60000, Morocco
- Intensive Care Unit, Mohammed VI University Hospital Center, Oujda, Morocco
- Mohammed First University Oujda, FMP Oujda, LAMCESM, Oujda, Morocco
- Anesthesiology and Intensive Care Unit Department, Mohammed First University, Faculty of Medicine and Pharmacy, Oujda, Morocco
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Kasitanon N, Hamijoyo L, Li MT, Oku K, Navarra S, Tanaka Y, Mok CC. Management of non-renal manifestations of systemic lupus erythematosus: A systematic literature review for the APLAR consensus statements. Int J Rheum Dis 2022; 25:1220-1229. [PMID: 35916201 DOI: 10.1111/1756-185x.14413] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 05/31/2022] [Accepted: 07/03/2022] [Indexed: 11/30/2022]
Abstract
The prevalence of systemic lupus erythematosus (SLE) is higher in Asians than Caucasians, with higher frequency of renal and other major organ manifestations that carry a poorer prognosis. The outcome of SLE is still unsatisfactory in many parts of the Asia Pacific region due to limited access to healthcare systems, poor treatment adherence and adverse reactions to therapies. The Asia Pacific League of Associations for Rheumatology (APLAR) SLE special interest group has recently published a set of consensus recommendation statements for the management of SLE in the Asia Pacific region. The current article is a supplement of systematic literature search (SLR) to the prevalence and treatment of non-renal manifestations of SLE in Asian patients.
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Affiliation(s)
- Nuntana Kasitanon
- Division of Rheumatology, Department of Internal Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Laniyati Hamijoyo
- Rheumatology Division, Department of Internal Medicine, Padjadjaran University, Bandung, Indonesia
| | - Meng Tao Li
- Department of Rheumatology, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Science, National Clinical Research Center for Dermatologic and Immunologic Diseases, Ministry of Science & Technology, Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, China
| | - Kenji Oku
- Department of Rheumatology, Endocrinology and Nephrology Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Sandra Navarra
- Section of Rheumatology, University of Santo Tomas Hospital, Manila, Philippines
| | - Yoshiya Tanaka
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Chi Chiu Mok
- Division of Rheumatology, Department of Medicine, Tuen Mun Hospital, Hong Kong SAR, China
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Mak A, Ho RCM, Lau CS. Clinical implications of neuropsychiatric systemic lupus erythematosus. ACTA ACUST UNITED AC 2018. [DOI: 10.1192/apt.bp.108.005785] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
SummarySystemic lupus erythematosus (SLE) is a disorder which can affect the central nervous system and result in a broad range of psychiatric syndromes such as psychosis, mood disorders, acute confusion and cognitive dysfunction. Despite the robust nomenclature of neuropsychiatric SLE (NPSLE), psychiatric syndromes in patients are often non-specific and may be secondary to concurrent non-SLE-related conditions and complications of medical therapies. Although the exact immunopathological mechanism for psychiatric presentation remains elusive, prompt exclusion of other factors contributing to the psychiatric symptoms coupled with effective assessment strategies and management with immunosuppression and psychiatric therapy are imperative. Psychiatrists and rheumatologists must work in close liaison to identify, treat and prognosticate patients with psychiatric syndromes in order to improve their quality of life, vocational aptitude and, ultimately, survival.
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Salviati M, Ortona E, Colasanti T, Francia A, Pontecorvo S, Delle Chiaie R. Olanzapine-induced neutropenia in a patient with systemiclupus erythematosus: a role of FcγRIIIb polymorphism? Lupus 2011; 21:97-9. [DOI: 10.1177/0961203311415889] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
In this study, we report the case of a Chinese patient with systemic lupus erythematosus (SLE) who developed neutropenia after treatment by olanzapine for the SLE-related psychiatric symptoms. The relationship between agranulocytosis, SLE and olanzapine is still unknown. Fcγ receptor IIIb (FcγRIIIb) is a low-affinity receptor, constitutively expressed only by neutrophils; NA1 and NA2 have been identified as representing polymorphisms of FcγRIIIb. NA1 is associated with the incidence of autoimmune neutropenia and is particularly frequent in Asiatic ethnic groups. The Chinese patient resulted to be homozygous for NA1. We suggest that the presence of NA1 allele may be a predisposing factor to olanzapine-induced agranulocytosis in patients with SLE. Hence, the analysis of FcγRIIIb polymorphism should be investigated in other cases of antipsychotic-induced agranulocytosis.
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Affiliation(s)
- M Salviati
- Department of Psychiatric Sciences and Psychological Medicine, ‘Sapienza’ University of Rome, Italy
| | - E Ortona
- Department of Cell Biology and Neurosciences, Istituto Superiore di Sanità, Rome, Italy
| | - T Colasanti
- Department of Cell Biology and Neurosciences, Istituto Superiore di Sanità, Rome, Italy
- Istituto San Raffaele Sulmona, Sulmona (AQ), Italy
| | - A Francia
- Department of Neurological Sciences, ‘Sapienza’ University of Rome, Italy
| | - S Pontecorvo
- Department of Neurological Sciences, ‘Sapienza’ University of Rome, Italy
| | - R Delle Chiaie
- Department of Psychiatric Sciences and Psychological Medicine, ‘Sapienza’ University of Rome, Italy
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Does switching to another antipsychotic in patients with clozapine-associated granulocytopenia solve the problem? Case series of 18 patients. J Clin Psychopharmacol 2011; 31:169-73. [PMID: 21346615 DOI: 10.1097/jcp.0b013e31820e3d9d] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
UNLABELLED Clozapine is a well-known drug that is used in treatment-resistant schizophrenia, but granulocytopenia, which may lead to a potentially fatal condition such as agranulocytosis, limit its use. The question about which antipsychotic should be used after a diagnosis of clozapine-associated granulocytopenia is difficult to answer, because antipsychotics other than clozapine may also have hematologic toxicity, or they may prolong clozapine-associated granulocytopenia. In this study, we aimed to find out the incidence of clozapine-associated granulocytopenia in our treatment sample and discuss suitable antipsychotic drug options in terms of hematologic toxicity, for management of clozapine-associated granulocytopenia. SUBJECTS One thousand five hundred twenty-four schizophrenia patients, treated with clozapine, were included in the study. METHODS Patients' white blood cell counts were monitored closely. Should granulocytopenia related to clozapine be diagnosed, clozapine was stopped immediately, and a new antipsychotic that the patient did not have a history of use was begun, according to the clinical profile of the patient. Persistent low white blood cell count after the 10th day of cessation of clozapine was accepted as prolongation effect. RESULTS Of the 1524 schizophrenia patients, 18 were diagnosed to have granulocytopenia, which means that 1.18% of the clozapine users developed granulocytopenia related to clozapine. Six of the patients were treated with olanzapine, 5 patients were treated with quetiapine, 1 patient was treated with risperidone, and 6 patients were treated with amisulpride after clozapine is stopped. None of the patients treated with risperidone or amisulpride showed prolonged low white blood cell count. Two of the patients treated with olanzapine (33.3%) and 2 of the patients treated with quetiapine (40.0%) showed prolonged leukopenia. DISCUSSION It is noteworthy that 33.3% of the patients treated with olanzapine and 40.0% of the patients treated with quetiapine showed prolonged leukopenia. This finding is also consistent with the literature that declares higher numbers of cases about prolongation of clozapine-associated granulocytopenia for olanzapine and quetiapine than risperidone and amisulpride. After switching to another antipsychotic drug, close monitoring of white blood cell count on a daily basis for the first 2 weeks should be continued until white blood cell counts are stabilized. Quetiapine and olanzapine especially need attention after clozapine-associated granulocytopenia. Further studies with larger series and longer follow-up should be carried out.
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Effects of clozapine and olanzapine on cytokine systems are closely linked to weight gain and drug-induced fever. Psychoneuroendocrinology 2009; 34:118-28. [PMID: 18835660 DOI: 10.1016/j.psyneuen.2008.08.016] [Citation(s) in RCA: 91] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2008] [Revised: 08/22/2008] [Accepted: 08/22/2008] [Indexed: 11/23/2022]
Abstract
The second generation antipsychotics clozapine and olanzapine are known to cause weight gain. However, only clozapine is associated with drug-induced fever. Cytokines have been linked to the induction of both weight gain and drug-induced fever. We investigated these potential side effects of clozapine and olanzapine and studied their differential effects on cytokine secretion. Thirty patients suffering from schizophrenia, schizophreniform disorder or schizoaffective disorder were treated with either clozapine (mean modal dose: 266.7+/-77.9mg) or olanzapine (21.2+/-2.5mg) in a randomized, double-blind, 6-week study. Body mass index (BMI), tympanic temperature, and plasma levels of leptin and cytokines (tumor necrosis factor-alpha (TNF-alpha), soluble TNF receptor 1 and 2 (sTNFR-1/2), soluble interleukin-2 receptors (sIL-2R), interleukin-6) were determined weekly. BMI, leptin and cytokines significantly increased over time, except interleukin-6 and sTNFR-1 in the olanzapine group. All cytokines numerically increased compared to baseline already during the first week of treatment in both groups. Leptin, TNF-alpha, sTNFR-1, sTNFR-2 and sIL-2R levels correlated with the BMI. Five patients who received clozapine (33%) developed drug-induced fever (>/=38 degrees C). In these, interleukin-6 peak levels were significantly (p<0.01) higher than in those patients treated with clozapine who did not develop fever. In conclusion, increase of BMI appears to be related to clozapine's and olanzapine's similar effects on cytokine systems, whilst drug-induced fever appears to be related to clozapine's differential effects on interleukin-6.
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