Possible Olanzapine-Induced Drug Fever: A Case Report

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<p>藥物熱，指的是使用藥物後直接或間接引起的發燒，之前的文獻中對藥物熱相關的風險因子與臨床表現，沒有一致的描述。而津普速(olanzapine)是一種非典型抗精神藥物，主要用於治療思覺失調症及雙極性情感疾患，常見的副作用包括代謝症候群、嗜睡等等，發燒的發生機率極低，少於千分之一。</p> <p>本篇個案報告為一位59歲女性在使用津普速後，發生發燒的現象，在排除可能原因後，推斷為罕見的津普速相關的藥物熱，在停用藥物之後發燒即緩解。在本篇個案報告中，我們統整了過去相關的文獻，試圖描繪出津普速引起之藥物熱的臨床特徵，討論可能的風險因子。希望藉此個案報告，讓基層醫師在鑑別診斷多重用藥病人的發燒時，能想到可能是罕見但能夠立即處理的津普速相關的藥物熱。</p> <p> </p><p>Drug fever refers to a febrile response with the administration of a drug in the absence of underlying conditions responsible for the fever and will disappear once the offending drug is discontinued. There is little agreement on possible risk factors and the clinical presentation of drug fever. Olanzapine is an atypical antipsychotic agent used in the management of schizophrenia and bipolar disorders. Fever as an adverse event was fewer than 1/1,000 patients on the FDA label.</p> <p>Here, we introduce a woman who presented with fever after using olanzapine. After we evaluated possible differentials, drug-related fever was suspected and the fever had subsided after stopping the medication. We tried to summarize previous articles which mentioned olanzapine related fever, and had depicted the clinical image and possible trigger factors of olanzapine-related fever. The present case report is expected to contribute to our understanding of the clinical picture of olanzapine-related fever and provides important information for primary care physicians when faced a patient with drugs related fever.</p> <p> </p>