Clozapine-induced elevated C-reactive protein and fever mimic infection

Gen Hosp Psychiatry. 2013 Nov-Dec;35(6):680.e5-6. doi: 10.1016/j.genhosppsych.2013.03.022. Epub 2013 Apr 28.

Abstract

Clozapine-induced fever has been reported frequently, but clozapine-induced elevated serum C-reactive protein (S-CRP) over 100 mg/L with early onset, without associated myocarditis, has not been reported in the literature. In this case report, we present a case of an 80-year-old Slovenian female with dementia and psychotic symptoms who developed elevated S-CRP (122 mg/L) and fever (38.2 °C) on the seventh day with 25 mg of clozapine daily, which improved after clozapine discontinuation. The patient did not have symptoms and signs of infection. This case report can be used to remind clinicians of keeping in mind the potential of clozapine associated with very high elevated S-CRP with fever, which can be easily confused with more serious conditions.

Keywords: Case report; Clozapine; Elevated C-reactive protein; Mimic infection.

Publication types

  • Case Reports

MeSH terms

  • Aged, 80 and over
  • Antipsychotic Agents / adverse effects*
  • C-Reactive Protein / drug effects
  • C-Reactive Protein / metabolism*
  • Clozapine / adverse effects*
  • Dementia / complications
  • Diagnosis, Differential
  • Female
  • Fever / chemically induced*
  • Fever / diagnosis
  • Humans
  • Infections / diagnosis
  • Psychotic Disorders / complications
  • Psychotic Disorders / drug therapy*

Substances

  • Antipsychotic Agents
  • C-Reactive Protein
  • Clozapine