The role of coagulation marker fibrin D-dimer in early diagnosis of catatonia

Catatonia and the immune system: a review

“…45 One study found the acutephase marker, and fibrin degradation product, Ddimer to be raised in all 25 catatonic patients tested, with a mean value 3 times higher than in noncatatonic psychiatric patients. 38 This finding is consistent with the increased risk of venous thromboembolism in catatonia, but has not yet been replicated.…”

“…41,43 When catatonic patients have been compared with psychiatric controls however, the results have been ambiguous. 38,42,44 The authors of one of the negative studies that used unmedicated patients speculated that iron might have been reduced in other reports because of the effect of antipsychotic medi cations. 44 In several studies, low serum iron in catatonia has been associated with the subsequent development of neuroleptic malignant syndrome.…”

An Unusual Presentation of Catatonia in a Patient with Schizoaffective Disorder

“…The dose reduction of risperidone in the case patient may have contributed to the recovery in D-dimer levels. Second, dopamine hypofunction, which could enhance vasoconstrictor norepinephrine basal tone, is the suggested mechanism in their study [ 3 ] . Nevertheless, our patient did not show others signals of the presumed noradrenergic hyperactivity.…”

“…Second, mild catatonic symptoms could present as a depressive episode without psychomotor disturbance, leading to a pitfall of underdiagnosis in patients with or without a history of recurrent depression. Third, it has been suggested that elevated D-dimer levels might be associated with the development of catatonia [ 3 ] . In clinical practice, the diagnosis of catatonia is made from the clinical signs and course and verifi ed by the response to lorazepam.…”

“…The case study has two major limitations. First, the authors found that the neuroleptically treated catatonic patients showed signifi cantly higher D-dimer levels than the non-neuroleptically treated catatonic patients [ 3 ] . Thus, neuroleptic treatment might be a risk factor in the increase of D-dimer levels only for patients with catatonia, suggesting a possible confound in that study and this case.…”