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Case Reports
. 2017 Jan 2;31(1):141-143.
doi: 10.21873/invivo.11037.

Clozapine Associated with Autoimmune Reaction, Fever and Low Level Cardiotoxicity - A Case Report

Charilaos Gerasimou  1 , Georgia Phaedra Vitali  1 , George D Vavougios  2   3 , Charalabos Papageorgiou  4 , Athanasios Douzenis  1 , Styliani I Kokoris  4 , Ioannis Liappas  5 , Emmanouil Rizos  6
Affiliations
Case Reports

Clozapine Associated with Autoimmune Reaction, Fever and Low Level Cardiotoxicity - A Case Report

Charilaos Gerasimou et al. In Vivo. .

Abstract

Background: Clozapine is a second-generation antipsychotic drug used in treatment-resistant schizophrenia. Fever induced by clozapine is a rather frequent side-effect which usually occurs in the first 4 weeks of treatment. Despite its effectiveness, there are potentially life-threatening adverse effects, such as cardiotoxicity.

Case report: We present the case of a 31-year-old caucasian male with refractory schizophrenia who developed benign fever, increase of C-reactive protein and high troponin levels, without presenting any other signs to myocarditis, on the 13th day under clozapine treatment, which declined progressively upon discontinuation of the drug.

Discussion: This case hints at the presence of initially subclinical cardiotoxicity as an underlying factor in patients developing fever.

Conclusion: Taking advantage of more sensitive methods for measuring troponin, clinicians would be promptly aware of this possible side-effect. This would allow for significant reduction of the risk of cardiac dysfunction, further attained by carefully monitoring the patient.

Keywords: Cardiotoxicity; case report; clozapine; fever; schizophrenia.

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