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Case Report

A Rare Case of Complicated Neuroleptic Malignant Syndrome with Rhabdomyolysis and Acute Kidney Injury

Sarat Kumar Naidu DNB Resident, Department of Emergency Medicine Max Hospital, Shalimar Bagh, New Delhi, Delhi 110088, India. , Sarat Kumar Naidu1 , Gurjit Kaur2 , Vikram Shah1 , Kishalay Datta3

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Indian Journal of Emergency Medicine 3(2):p 304-307, Jul-Dec 2017. | DOI: http://dx.doi.org/10.21088/ijem.2395.311X.3217.29

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Abstract

A 38 years old female, a known case of MDP/Schizophrenia, was brought to ED with 5 days h/o high fever, tightness of whole body, altered mental status, reduced urine output, inability to eat and speak, following an intake of an atypical antipsychotic Amisulpiride 100mg over period of 23 days prior to symptoms. With the history, physical examination and investigations, a diagnosis of neuroleptic malignant syndrome (NMS) with rhabdomyolysis and acute kidney injury (AKI) was made and supportive treatment started with hydration, dopamine agonism, anticholinergic drugs and urine alkalinization. She started improving after 1 week of aggressive treatment and was discharged in stable condition after 3 weeks.

Keywords: Neuroleptic Malignant Syndrome; Manic Depressive Psychosis; MDP; Schizophrenia; Muscle Rigidity; Rhabdomyolysis; Acute Kidney Injury; Kidney Failure; Amisulpiride; Antipsychotic; Neuroleptic; Idiosyncratic; Dopamine; Dopaminergic; Prolonged QTc; Urine Alkalinization; Creatinine Phosphor Kinase; CPK. 

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DOI: http://dx.doi.org/10.21088/ijem.2395.311X.3217.29

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