Rhabdomyolysis secondary to malignant syndrome caused by buspirone combined with lorazepam
10.3760/cma.j.cn114015-20210914-00995
- VernacularTitle:丁螺环酮与劳拉西泮联用致恶性综合征继发横纹肌溶解症
- Author:
Bing WANG
1
;
Guangjie ZHOU
;
Jinfeng LI
;
Huaying TANG
;
Ailun ZHANG
;
Huixuan HUANG
Author Information
1. 威海市立医院药剂科，威海 264200
- Publication Type:Journal Article
- Keywords:
Buspirone;
Lorazepam;
Neuroleptic malignant syndrome;
Rhabdomyolysis
- From:
Adverse Drug Reactions Journal
2022;24(4):220-222
- CountryChina
- Language:Chinese
-
Abstract:
A 66-year-old male patient with anxiety and depression received lorazepam 1 mg twice daily and buspirone 10 mg twice daily. Two months later, the patient developed chills, fever, drowsiness, and stiffness of limbs, etc. Laboratory tests showed white blood cell count 13.5×10 9/L, neutrophils 0.89, C-reactive protein 68.7 mg/L, serum creatinine 211 mmol/L, direct bilirubin 10.3 mmol/L, alanine aminotransferase 96 U/L, aspartate aminotransferase 121 U/L, creatine kinase (CK) 4 557 U/L, CK-MB 83 U/L, lactate dehydrogenase 462 U/L, α-hydroxybutyrate dehydrogenase 339 U/L, and troponin 116 ng/L. Malignant syndrome caused by buspirone was considered. The drug was stopped, lorazepam was continued, and oxygen inhalation, ECG monitoring, physical cooling, anti-infection, and other treatments were given. The patient still had fever and developed deep coma, with brown urine and myoglobin >3 000 mg/L. Secondary rhabdomyolysis was considered. Anti-infection treatment was continued and treatments such as correcting electrolyte balance, alkalizing urine, and diuresis were given. On the 10th day of drug withdrawal, the patient had normal limb activity and urine color, his creatine kinase was 246 U/L, and myoglobin was 856 mg/L. One month later, the laboratory tests showed no obvious abnormalities and no malignant syndrome releted symptoms recurred. The rhabdomyolysis secondary to malignant syndrome in the patient was considered to be possibly related to buspiron and the combination with lorazepam might promote its occurrence.
