疑似停用Levodopa／Benserazide及Amantadine所引起的類帕金森高熱症候群之案例報告及文獻回顧

Levodopa/Benserazide and Amantadine Withdrawal Associated Parkinsonism Hyperpyrexia Syndrome: A Case Report and Literature Review

林志忠(Chih-Chung Lin) ； 陳彥佐(Yan-Zuo Chen) ； 吳建志(Chien-Chih Wu)

《臺灣臨床藥學雜誌》 27卷3期 (2019/07) Pp. 245-253

https://doi.org/10.6168/FJCP.201907_27(3).0009

摘要

當腦中多巴胺系統受到抑制，不論是使用抗精神藥品或是長期使用多巴胺補充劑後突然停藥或減量，臨床上皆可能產生高體熱、肌肉僵硬、精神狀態改變、自律神經系統異常及橫紋肌溶解等症狀。前者稱為抗精神病藥品引起之惡性症候群；後者稱為類帕金森高熱症候群，臨床上皆為罕見所以容易被忽略。本案例為一帕金森氏症患者因呼吸喘及意識不清入院治療，其抗帕金森氏症藥品未及時加回使用，於入院2天後即發生類帕金森高熱症候群導致急性腎衰竭而需要腎臟替代療法治療。希望藉由本案例報告及文獻回顧，能讓更多臨床醫療人員注意到帕金森氏症患者用藥連貫的重要性，以避免嚴重不良反應的發生。

關鍵字

惡性高熱 ； 類帕金森高熱症候群 ； 橫紋肌溶解

並列摘要

Inhibition of the dopamine system in the brain, probably due to the use of antipsychotic agents or withdrawal of dopamine agonists, may lead to hyperpyrexia, rigidity, alteration in mental status, autonomic instability, or rhabdomyolysis. This disorder is known as neuroleptic malignant syndrome or parkinsonism hyperpyrexia syndrome based on the use of antipsychotic agents or withdrawal of anti-parkinsonism drugs. This syndrome is easily ignored because of its extremely low incidence. We report a case of a patient who did not continue using her anti-parkinsonism drugs after admission to the hospital, and she was found to have parkinsonism hyperpyrexia syndrome, which resulted in acute renal failure requiring renal replacement therapy afterwards. Therefore, it is important to conduct medication reconciliation for patients with Parkinson’s disease to prevent severe adverse effects.

並列關鍵字

Malignant Hyperthermia ； Parkinsonism Hyperpyrexia Syndrome ； Rhabdomyolysis