TY - JOUR
TI - Clozapine associated with autoimmune reaction, fever and low level cardiotoxicity - a case report
AU - Gerasimou, C.
AU - Vitali, G.P.
AU - Vavougios, G.D.
AU - Papageorgiou, C.
AU - Douzenis, A.
AU - Kokoris, S.I.
AU - Liappas, I.
AU - Rizos, E.
JO - In vivo (Athens, Greece)
PY - 2017
VL - 31
TODO - 1
SP - 141-144
PB - International Institute of Anticancer Research
SN - null
TODO - 10.21873/invivo.11037
TODO - C reactive protein;  clozapine;  creatine kinase MB;  lorazepam;  paracetamol;  procalcitonin;  troponin;  clozapine;  neuroleptic agent, adult;  agitation;  Article;  auditory hallucination;  autoimmune disease;  cardiotoxicity;  case report;  delusional disorder;  drug dose increase;  drug dose titration;  drug withdrawal;  electrocardiography;  fever;  gene expression;  human;  leukocyte count;  leukocytosis;  male;  Mini Mental State Examination;  myocarditis;  neutrophil;  rigor;  schizophrenia;  sinus tachycardia;  sweating;  tachycardia;  thorax radiography;  urinalysis;  autoimmunity;  cardiotoxicity;  chemically induced;  drug effects;  fever, Adult;  Antipsychotic Agents;  Autoimmunity;  Cardiotoxicity;  Clozapine;  Electrocardiography;  Fever;  Humans;  Male;  Schizophrenia
TODO - 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.
ER -