Severe ischemic colitis following olanzapine use - A case report

Alves, Rosa; Correia, Luís; Gonçalves, Ana; Malaquias, João; Oliveira, E S; Velosa, José

doi:10.17235/reed.2016.3944/2015

Cited by 8 publications

(8 citation statements)

References 14 publications

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“…Segmental ischemic colitis in young patients is an uncommon disease and the main cause is cocaine abuse (2). However, there are other less frequent causes such as intestinal inflammatory disease, autoimmune vasculitis, myointimal hyperplasia of mesenteric vein, infectious colitis and neuroleptic drugs (1,3). This patient was under treatment with four antiepileptic drugs although; intestinal ischemia is not one of its side effects.…”

Section: Discussionmentioning

confidence: 90%

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Segmental intestinal necrosis in a young patient

Martínez-Fernández

2017

Rev Esp Enferm Dig

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Section: Discussionmentioning

confidence: 90%

“…Segmental colon ischemia is an unusual disease that is mainly caused by cocaine abuse as described by Fernandes (1).…”

Section: Dear Editormentioning

confidence: 99%

Segmental intestinal necrosis in a young patient

Martínez-Fernández

2017

Rev Esp Enferm Dig

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“…The cholinergic, serotonergic, and 5-HT3 gastrointestinal receptors were inhibited by olanzapine, which promoted gastrointestinal hypomotility, and this may be the main mechanism of olanzapine-induced paralytic ileus. 18 , 19 Paralytic ileus includes the classical symptoms of alimentary tract hemorrhage and causes anemia in the early phase. Initially, we considered anemia to be related to olanzapine poisoning until the patient’s bowel sounds became hyperactive and melena was passed.…”

Section: Discussionmentioning

confidence: 99%

Gluteal muscle damage and rhabdomyolysis after olanzapine poisoning: a case report

Cui

Jian

et al. 2021

J Int Med Res

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Olanzapine is a widely adopted atypical antipsychotic medication used to manage schizophrenia. Reports show that the incidence rate of adverse reactions to olanzapine is significantly lower than those of other classic antipsychotic medications. However, olanzapine overdose may be associated with severe consequences. Herein, we report a 21-year-old female patient who had taken nearly 700 mg (70 tablets) of olanzapine; she was found after 30 hours. As her condition progressed, she presented with rhabdomyolysis, swelling in the thighs and hips, paralytic ileus, digestive tract hemorrhage, and elevated serum amylase and lipase levels; notably, she recovered after treatment. This intractable case is of great clinical significance and suggests that early-phase hemoperfusion plays a critical role in olanzapine poisoning-related rhabdomyolysis.

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“…The aetiology for this severe outcome is unclear but it is speculated that the anticholinergic medication decreased peristalsis, which could lead to the ischaemic injury. Less severe presentations of colonic ischaemia, improving with conservative measures have been documented when quetiapine was taken in combination with other medications including the anti‐convulsant oxcarbazepine, olanzapine and other psychotropics …”

Section: Pharmacologic Agents Moderately Associated With Colon Ischaemiamentioning

confidence: 99%

Review article: the pharmacological causes of colon ischaemia

Vodusek

Feuerstadt

Brandt

2018

Aliment Pharmacol Ther

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Summary Background Colon ischaemia is the most common ischaemic disorder of the gastrointestinal system, can affect any segment of the colon, and may present with a range of symptoms. Diagnosis can be challenging due to symptom overlap with other conditions, varied aetiology, and often rapid and self‐resolving course. Aim To review comprehensively the literature regarding the pharmacological aetiologies of colonic ischaemia to enhance the understanding of the various mechanisms of disease, presentations, distribution, and outcomes. Methods A PubMed search for “colon ischaemia” and “ischaemic colitis” alone as well as in combination with various known pharmacologic causes was performed. Only the highest quality and relevant literature was included in this review. The quality of the literature for each association was rated by the authors and a consensus was made when discrepancies were encountered. Only associations that were deemed “moderate” or “strong” were included. Results The literature considering pharmacologically associated colonic ischaemia is diverse, lacks codification and is characterised by numerous case reports and case series. Constipation‐inducing drugs, digoxin, hormonal therapies, illicit drugs, immunomodulators, laxatives, and NSAIDs were strongly associated with colonic ischaemia. Antimicrobials, appetite suppressants, chemotherapies, decongestants, diuretics, ergot alkaloids, serotonin agents, statins, and vasopressor agents were moderately associated. Conclusions Patients presenting with abdominal pain, diarrhoea, or bloody stool need to be evaluated for the possibility of this condition and treated accordingly. Timely diagnosis is necessary to improve patient outcomes. This review aims to increase awareness among clinicians regarding the presentation of pharmacologically induced colonic ischaemia.

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Severe ischemic colitis following olanzapine use - A case report

Cited by 8 publications

References 14 publications

Segmental intestinal necrosis in a young patient

Segmental intestinal necrosis in a young patient

Gluteal muscle damage and rhabdomyolysis after olanzapine poisoning: a case report

Review article: the pharmacological causes of colon ischaemia

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