A renal transplant patient with intractable hiccups and review of the literature

Rosenberger, Jaroslav; Veselíny, Eduard; Beňa, Ľ; Roland, Róbert

doi:10.1111/j.1399-3062.2005.00096.x

Cited by 13 publications

(11 citation statements)

References 14 publications

(17 reference statements)

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“…There are several case reports in the literature regarding hiccups in transplant recipients. One study reported that hiccups in the early posttransplant period are typically due to infections or adverse effects of drugs such as steroids and anesthetics . They state that in later periods, the most common causes are infections and tumors.…”

Section: Discussionmentioning

confidence: 99%

“…One study reported that hiccups in the early posttransplant period are typically due to infections or adverse effects of drugs such as steroids and anesthetics. 1 They state that in later periods, the most common causes are infections and tumors. Our patient's hiccups began to occur before his transplantation but then returned more persistently approximately 4 month after transplantation.…”

Section: Discussionmentioning

confidence: 99%

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Olanzapine and Baclofen for the Treatment of Intractable Hiccups

2013

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Intractable hiccups are a relatively uncommon condition characterized by involuntary, spasmodic contractions of the diaphragm. This type of hiccups generally has a duration of more than 1 month. We describe a 59-year-old kidney transplant recipient with a complicated medical history (atrial fibrillation, chronic renal failure, type 2 diabetes mellitus, gastroesophageal reflux, gout, hypertension, hyperlipidemia, and obstructive sleep apnea) who developed intractable hiccups that significantly affected his quality of life. Despite an extensive gastrointestinal and pulmonary evaluation, and treatment failures with several different drug regimens--metoclopramide, desipramine, amantadine, cyclobenzaprine, phenytoin, and lorazepam--his hiccups were eventually controlled with a combination of baclofen and low-dose olanzapine therapy. Baclofen is a c-aminobutyric acid (GABA) analog that contains a phenylethylamine moiety. It is hypothesized that having both GABA and phenylethylamine properties activates inhibitory neurotransmitters, most notably GABA, which may in turn block the hiccup stimulus. The exact mechanism through which olanzapine is effective in patients with hiccups is not fully understood. It is thought that the effect is, in part, due to serotonin augmenting phrenic motoneuronal activity on the reflex arcs involved in the generation of hiccups within the spinal cord. In addition, since olanazapine is a dopamine antagonist, particularly a dopamine D₂-receptor antagonist, this could also have played a role in its effectiveness in treating our patient. Strong evidence for a specific treatment regimen for intractable hiccups is lacking in the primary literature. Our case report adds to the available literature, as there are currently no published data on the use of combination therapy for the treatment of intractable hiccups, and the combination of baclofen and olanzapine significantly improved our patient's quality of life.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Olanzapine and Baclofen for the Treatment of Intractable Hiccups

2013

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“…3 However, hiccups have been reported in a wide variety of pathologies, including malignancy and various organ transplants. 4,5 Hiccups are infrequent phenomena during seizures of any type. From our review of the literature only Fogarasi et al, have reported hiccups associated with complex partial seizures; their report on childhood partial seizures included one patient with hiccups although it is not clear whether these happened during the ictal or post-ictal periods.…”

Section: Discussionmentioning

confidence: 99%