血清ミオグロビンの異常高値に対してwash-out療法が有効であった悪性症候群の1例

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  • Successful Treatment of High Elevation of Serum Myoglobin by Wash-out Therapy in a Patient with Neuroleptic Malignant Syndrome

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A case of neuroleptic malignant syndrome with a high elevation of serum myoglobin was successfully treated by wash-out therapy.<br>A 34-year-old man developed neuroleptic malignant syndrome after an intramuscular injection of fluphenazine. The laboratory examination showed remarkable increases in serum myoglobin and creatine phosphokinase (CPK) (maximum values: 15×104ng·ml-1, 49.7×104IU·l-1, respectively). Continuous infusions of mannitol and furosemide, and volume expansion were carried out to increase urinary flow. Urinary output increased up to 13 liters per day, and serum myoglobin, and CPK decreased dramatically.<br>This case suggested that wash-out therapy was effective in preventing acute renal failure which is often seen in neuroleptic malignant syndrome accompanying a remarkable increase in serum myoglobin.

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