Clozapine-Induced Cardiotoxicity Presenting as Sepsis: A Case Report and Literature Review

Joint Authors

Yang, Ying chi
Khalid, Mazin
Jegede, Oluwole
Gayam, Vijay
Shrestha, Binav
Mandal, Amrendra
Mukhtar, Osama
Garlapati, Pavani
Khalid, Mowyad
Dufresne, Alix

Source

Case Reports in Medicine

Issue

Vol. 2019, Issue 2019 (31 Dec. 2019), pp.1-6, 6 p.

Publisher

Hindawi Publishing Corporation

Publication Date

2019-03-31

Country of Publication

Egypt

No. of Pages

6

Main Subjects

Medicine

Abstract EN

Clozapine is an atypical antipsychotic agent indicated in the treatment of medication-resistant schizophrenia.

It is often reserved as a last line of treatment owing to the potential for serious and potentially life-threatening side effects, the most serious being agranulocytosis requiring close hematological monitoring and possible discontinuation of the medication from further use in the patient even when the agranulocytosis resolves.

Other complications of clozapine include sedation, weight gain, elevated triglyceride levels, postural hypotension, and tachycardia.

However, the potentially serious complication of myocarditis, though rare (with an incidence of 3%), may lead to cardiomyopathy as described in our present case.

We present a 21-year-old patient who was started on clozapine for management of schizophrenia.

He developed fever and tachycardia and was admitted to the medical unit on intravenous antibiotics for management of sepsis as he met the criteria for systemic inflammatory response syndrome.

His labs revealed an elevated troponin and trending eosinophilia, which, in the context of clozapine use, raises the suspicion of clozapine cardiotoxicity.

Echocardiogram showed reduced systolic function (45%).

Clozapine was immediately discontinued, and his repeat echocardiogram showed normalization of his systolic function.

In view of the increased prevalence of psychiatric illnesses, internists should be aware of rare but potentially life-threatening side effects.

American Psychological Association (APA)

Khalid, Mazin& Jegede, Oluwole& Gayam, Vijay& Yang, Ying chi& Shrestha, Binav& Mandal, Amrendra…[et al.]. 2019. Clozapine-Induced Cardiotoxicity Presenting as Sepsis: A Case Report and Literature Review. Case Reports in Medicine،Vol. 2019, no. 2019, pp.1-6.
https://search.emarefa.net/detail/BIM-1137293

Modern Language Association (MLA)

Khalid, Mazin…[et al.]. Clozapine-Induced Cardiotoxicity Presenting as Sepsis: A Case Report and Literature Review. Case Reports in Medicine No. 2019 (2019), pp.1-6.
https://search.emarefa.net/detail/BIM-1137293

American Medical Association (AMA)

Khalid, Mazin& Jegede, Oluwole& Gayam, Vijay& Yang, Ying chi& Shrestha, Binav& Mandal, Amrendra…[et al.]. Clozapine-Induced Cardiotoxicity Presenting as Sepsis: A Case Report and Literature Review. Case Reports in Medicine. 2019. Vol. 2019, no. 2019, pp.1-6.
https://search.emarefa.net/detail/BIM-1137293

Data Type

Journal Articles

Language

English

Notes

Includes bibliographical references

Record ID

BIM-1137293