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Unrecognized clozapine-related constipation leading to fatal intra-abdominal sepsis – a case report
Clozapine is the preferred antipsychotic used for the treatment of resistant schizophrenia with suicidal ideation. The drug is started at a low dose and gradually increased to a target dose of 300–450 mg/day. It is well known to cause agranulocytosis and neutropenia. Several cases of fatal sepsis ha...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Dove Medical Press
2015
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4573205/ https://www.ncbi.nlm.nih.gov/pubmed/26392790 http://dx.doi.org/10.2147/IMCRJ.S86716 |
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author | Oke, Vikram Schmidt, Frances Bhattarai, Bikash Basunia, Md Agu, Chidozie Kaur, Amrit Enriquez, Danilo Quist, Joseph Salhan, Divya Gayam, Vijay Mungikar, Prajakta |
author_facet | Oke, Vikram Schmidt, Frances Bhattarai, Bikash Basunia, Md Agu, Chidozie Kaur, Amrit Enriquez, Danilo Quist, Joseph Salhan, Divya Gayam, Vijay Mungikar, Prajakta |
author_sort | Oke, Vikram |
collection | PubMed |
description | Clozapine is the preferred antipsychotic used for the treatment of resistant schizophrenia with suicidal ideation. The drug is started at a low dose and gradually increased to a target dose of 300–450 mg/day. It is well known to cause agranulocytosis and neutropenia. Several cases of fatal sepsis have been reported in neutropenic patients and emphasis is placed on monitoring for agranulocytosis; however, clozapine also causes intestinal hypomotility and constipation, which if unrecognized can lead to intestinal obstruction, bowel necrosis, and intra-abdominal sepsis. Reduced behavioral pain reactivity in schizophrenics may alter the ability to express pain, potentially leading to a delay in the presentation for medical attention. We report a case of fatal intra-abdominal sepsis secondary to an unrecognized case of clozapine-related constipation. |
format | Online Article Text |
id | pubmed-4573205 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | Dove Medical Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-45732052015-09-21 Unrecognized clozapine-related constipation leading to fatal intra-abdominal sepsis – a case report Oke, Vikram Schmidt, Frances Bhattarai, Bikash Basunia, Md Agu, Chidozie Kaur, Amrit Enriquez, Danilo Quist, Joseph Salhan, Divya Gayam, Vijay Mungikar, Prajakta Int Med Case Rep J Case Report Clozapine is the preferred antipsychotic used for the treatment of resistant schizophrenia with suicidal ideation. The drug is started at a low dose and gradually increased to a target dose of 300–450 mg/day. It is well known to cause agranulocytosis and neutropenia. Several cases of fatal sepsis have been reported in neutropenic patients and emphasis is placed on monitoring for agranulocytosis; however, clozapine also causes intestinal hypomotility and constipation, which if unrecognized can lead to intestinal obstruction, bowel necrosis, and intra-abdominal sepsis. Reduced behavioral pain reactivity in schizophrenics may alter the ability to express pain, potentially leading to a delay in the presentation for medical attention. We report a case of fatal intra-abdominal sepsis secondary to an unrecognized case of clozapine-related constipation. Dove Medical Press 2015-09-11 /pmc/articles/PMC4573205/ /pubmed/26392790 http://dx.doi.org/10.2147/IMCRJ.S86716 Text en © 2015 Oke et al. This work is published by Dove Medical Press Limited, and licensed under Creative Commons Attribution – Non Commercial (unported, v3.0) License The full terms of the License are available at http://creativecommons.org/licenses/by-nc/3.0/. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. |
spellingShingle | Case Report Oke, Vikram Schmidt, Frances Bhattarai, Bikash Basunia, Md Agu, Chidozie Kaur, Amrit Enriquez, Danilo Quist, Joseph Salhan, Divya Gayam, Vijay Mungikar, Prajakta Unrecognized clozapine-related constipation leading to fatal intra-abdominal sepsis – a case report |
title | Unrecognized clozapine-related constipation leading to fatal intra-abdominal sepsis – a case report |
title_full | Unrecognized clozapine-related constipation leading to fatal intra-abdominal sepsis – a case report |
title_fullStr | Unrecognized clozapine-related constipation leading to fatal intra-abdominal sepsis – a case report |
title_full_unstemmed | Unrecognized clozapine-related constipation leading to fatal intra-abdominal sepsis – a case report |
title_short | Unrecognized clozapine-related constipation leading to fatal intra-abdominal sepsis – a case report |
title_sort | unrecognized clozapine-related constipation leading to fatal intra-abdominal sepsis – a case report |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4573205/ https://www.ncbi.nlm.nih.gov/pubmed/26392790 http://dx.doi.org/10.2147/IMCRJ.S86716 |
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