A Case of Neuroleptic Malignant Syndrome with Acute Renal Failure after the Discontinuation of Sulpiride and Maprotiline.

Abstract

A 46-year-old man developed neuroleptic malignant syndrome with acute myoglobinuric renal failure after the discontinuation of sulpiride and maprotiline treatment. He showed the characteristic features of hyperpyrexia, altered consciousness, muscle rigidity, and autonomic dysfunction. Laboratory data showed lysis of skeletal muscle cells and renal impairment. Muscle biopsy revealed necrosis and regenerative changes in muscle fibers. Renal biopsy showed focal tubulitis and interstitial infiltration of small inflammatory cells. The combination of sulpiride and maprotiline has not previously been reported to be the cause of neuroleptic malignant syndromeand acute myoglobinuric renal failure.

A case of neuroleptic malignant syndrome in a patient with hemodialysis

“…Hemodialysis is effective to ameliorate myoglobinuric renal failure, 11 but not to remove amoxapine, which is strongly bound to serum lipids and proteins. 12 There are no pharmacokinetic data on amoxapine in hemodialysis patients and the serum level of amoxapine in this case was not measured.…”