Evidence map›Paper›PMID 34106671›Full record

ArticleMedicine2021

Successful diagnosis and treatment of pulmonary aspergillosis-related malignant catatonia using propofol and quetiapine: A case report.

Kazuhito Nomura, Sonoko Sakawaki, Eiji Sakawaki, Ayumu Yamaoka, Wakiko Aisaka, Hiroyuki Okamoto, Yoshihiro Takeyama, Shuji Uemura, Eichi Narimatsu

Open access · goldAbstract readCase Reports
In one paragraph

Article in Medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
0.5field-weighted citation impact, top 39% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 synthesis or guideline pooled it, 3 citations in OpenAlex.

  1. Guideline
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 4 institutions in 1 country.

Kazuhito NomuraDepartment of Emergency Medicine, Sapporo Medical University Hospital, Sapporo-shi.ORCID 0000-0001-8532-0166
Sonoko SakawakiDepartment of Emergency Medicine, Hakodate Municipal Hospital, Hakodate-shi.
Eiji SakawakiDepartment of Emergency Medicine, Hakodate Municipal Hospital, Hakodate-shi.
Ayumu YamaokaDepartment of Neurosurgery, Sunagawa City Medical Center, Sunagawa-shi.
Wakiko AisakaDepartment of Emergency Medicine, Sapporo Medical University Hospital, Sapporo-shi.
Hiroyuki OkamotoDepartment of Emergency Medicine, Teine Keijinkai Hospital, Sapporo-shi, Hokkaido, Japan.
Yoshihiro TakeyamaDepartment of Emergency Medicine, Hakodate Municipal Hospital, Hakodate-shi.
Shuji UemuraDepartment of Emergency Medicine, Sapporo Medical University Hospital, Sapporo-shi.
Eichi NarimatsuDepartment of Emergency Medicine, Sapporo Medical University Hospital, Sapporo-shi.
Sapporo Medical University Hospital · JPHakodate National Hospital · JPSunagawa City Medical Center · JPTeine Keijinkai Hospital · JP

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionMalignant catatonia (MC) is a movement disorder syndrome characterized by immobility, rigidity, and consciousness disorders that develops in association with mental and physical diseases. It is often fatal due to hyperthermia, rhabdomyolysis, and acute kidney injury. Its clinical symptoms are similar to those of another disorder, neuroleptic malignant syndrome (NMS), and it is often difficult to distinguish between the 2 disorders. PATIENT CONCERNS: An Asian woman in her 60s with history of schizophrenia. She was admitted to our hospital because of symptoms such as fever, unconsciousness, and muscle rigidity. Blood tests showed kidney injury and high creatinine kinase levels. DIAGNOSES: At the time of admission, she had been diagnosed with NMS complicated by pulmonary aspergillosis and was undergoing treatment although there was no improvement.

interventionsSubsequently, the administration of propofol, a gamma-aminobutyric acid A agonist, markedly improved the symptoms, and the diagnosis was corrected to MC. At the beginning of her hospitalization, she received dantrolene, bromocriptine, amantadine, and L-3,4-dihydroxyphenylalanine as treatment for NMS, but her symptoms did not improve. With propofol, which is used for sedation, her catatonic symptoms improved markedly. Quetiapine administration further improved the symptoms, and it eventually resolved completely. OUTCOMES: The patient's MC was in remission. Prolonged intensive care management resulted in a decline in activities of daily living, and she required rehabilitation at another hospital.

conclusionThis is the first report of MC with suspected involvement of pulmonary aspergillosis. MC differs from NMS, in that it is treated more effectively with gamma-aminobutyric acid A agonists. Although benzodiazepines are the first choice for the diagnosis and treatment of MC, they are ineffective for majority of patients with schizophrenia. However, even in such cases, propofol and quetiapine are effective, and they facilitate diagnosis and treatment.

Indexed as

CatatoniaDiagnosis, DifferentialFemaleHumansHypnotics and SedativesMiddle AgedNeuroleptic Malignant SyndromePropofolPulmonary AspergillosisQuetiapine FumarateRenal InsufficiencySchizophreniaHypnotics and SedativesPropofolQuetiapine Fumarate

Identifiers

PMID34106671
PMCPMC8133261
OpenAlexW3162270767

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.