临床误诊误治2018，Vol.31Issue(3)：26-29,4.DOI:10.3969/j.issn.1002-3429.2018.03.009
小剂量氯氮平中毒致多系统损害一例误诊分析
Analysis of Misdiagnosis of One Case of Multiple System Damage Due to Intoxication Induced by Low-dose Clozapine
摘要
Abstract
Objective To discuss clinical features and treatment measures of low-dose Clozapine intoxication.Methods The clinical data of a case suffering grave intoxication induced by low-dose Clozapine and misdiagnosed in our hospital were retrospectively analyzed.Results The patient was admitted to hospital for coma with mouth convulsion and salivation for 4 h and schizophrenia for ten years.He received long-term Clozapine (50 mg,2times/d) treatment on a regular basis.Brain MRI was unremarkable,however,chest CT showed increased markings in both lungs.Additionally,intracranial pressure monitored by lumbar puncture was 300 mmHg.Thus,he was initially misdiagnosed with status epilepticus,intracranial infection and pulmonary infection.The patient waking up after symptomatic treatment stated that he had taken Clozapine 100 mg before onset.The final diagnosis was Clozapine intoxication and the patient gradually improved and was discharged after comprehensive treatment including diuretics,reducing intracranial pressure,cholinolytics,tracheal intubation and assisted mechanical ventilator.Conclusion Given association between low-dose Clozapine and multisystem damage,heightened perceptions of the disease,comprehensive analysis and timely medical examinations are key to reducing misdiagnosis.关键词
中毒/氯氮平/误诊/癫痫持续状态Key words
Poisoning/Clozapine/Misdiagnosis/Status epilepticus分类
医药卫生引用本文复制引用
林进皇,洪春永,吴欣宇,曾友福,卢武生..小剂量氯氮平中毒致多系统损害一例误诊分析[J].临床误诊误治,2018,31(3):26-29,4.基金项目
中国人民解放军第一七五医院青年苗圃基金项目(16Y001) （16Y001）
