Clozapine Associated with Autoimmune Reaction, Fever and Low Level Cardiotoxicity - A Case Report

氯氮平相关自身免疫反应、发热和低水平心脏毒性——病例报告

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Abstract

BACKGROUND: Clozapine is a second-generation antipsychotic drug used in treatment-resistant schizophrenia. Fever induced by clozapine is a rather frequent side-effect which usually occurs in the first 4 weeks of treatment. Despite its effectiveness, there are potentially life-threatening adverse effects, such as cardiotoxicity. CASE REPORT: We present the case of a 31-year-old caucasian male with refractory schizophrenia who developed benign fever, increase of C-reactive protein and high troponin levels, without presenting any other signs to myocarditis, on the 13th day under clozapine treatment, which declined progressively upon discontinuation of the drug. DISCUSSION: This case hints at the presence of initially subclinical cardiotoxicity as an underlying factor in patients developing fever. CONCLUSION: Taking advantage of more sensitive methods for measuring troponin, clinicians would be promptly aware of this possible side-effect. This would allow for significant reduction of the risk of cardiac dysfunction, further attained by carefully monitoring the patient.

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