Ketiapin Tedavisi Altında Gelişen Atipik Pulmoner Emboli Olgusu
Özet
Antipsikotik ilaçlar ile venöz tromboembolizm (VTE) arasındaki ilişki giderek daha fazla dikkat çekmektedir. Bu olguda, ketiapin tedavisi altında atipik semptomlarla başvuran ve submasif pulmoner emboli tanısı alan genç bir hasta sunulmaktadır. Otuz üç yaşında erkek hasta, senkop, çarpıntı ve anksiyete benzeri yakınmalar ile acil servise başvurmuştur. Klinik değerlendirme, laboratuvar ve görüntüleme bulguları ile submasif pulmoner emboli tanısı konulmuştur. Yoğun bakım takibi ve antikoagülan tedavi sonrası klinik iyileşme sağlanmıştır. Bu olgu, ketiapin gibi sedatif etkisi belirgin antipsikotiklerin, atipik klinik prezentasyonlarla seyreden pulmoner emboli ile ilişkili olabileceğini göstermektedir.
The association between antipsychotic medications and venous thromboembolism (VTE) has been receiving increasing attention. In this case, we present a young patient who was diagnosed with submassive pulmonary embolism and presented with atypical symptoms while under quetiapine treatment. A 33-year-old male patient was admitted to the emergency department with complaints of syncope, palpitations, and anxiety-like symptoms. Based on clinical evaluation, laboratory findings, and imaging results, a diagnosis of submassive pulmonary embolism was established. Clinical improvement was achieved following intensive care monitoring and anticoagulant therapy. This case suggests that antipsychotics with prominent sedative effects, such as quetiapine, may be associated with pulmonary embolism presenting with atypical clinical manifestations.
Referanslar
Goldhaber SZ. Pulmonary embolism. N Engl J Med. 1998;339(2):93-104. doi:10.1056/NEJM199807093390207
Stein PD, Beemath A, Matta F, et al. Clinical characteristics of patients with acute pulmonary embolism. Am J Med. 2007;120(10):871-879. doi:10.1016/j.amjmed.2007.03.024
Zornberg GL, Jick H. Antipsychotic drug use and risk of first-time idiopathic venous thromboembolism: a case-control study. Lancet. 2000;356(9237):1219-1223. doi:10.1016/S0140-6736(00)02784-7
Parker C, Coupland C, Hippisley-Cox J. Antipsychotic drugs and risk of venous thromboembolism: nested case-control study. BMJ. 2010;341:c4245. doi:10.1136/bmj.c4245
Barbui C, Conti V, Cipriani A, et al. Antipsychotic drug exposure and risk of venous thromboembolism: a systematic review and meta-analysis. Drug Saf. 2014;37(2):79-90. doi:10.1007/s40264-013-0120-6
Lacut K, Le Gal G, Couturaud F, et al. Association between antipsychotic drugs, antidepressants, and venous thromboembolism: results from a case-control study. J Thromb Haemost. 2007;5(7):1471-1477. doi:10.1111/j.1538-7836.2007.02587.x
Hägg S, Spigset O. Antipsychotic-induced venous thromboembolism. CNS Drugs. 2002;16(11):765-776. doi:10.2165/00023210-200216110-00004
Huang J, Zou F, Zhu J, Wu Z, Lin C, Wei P, Su H, Li M, Huang Q, Cai J. Association between antipsychotics and pulmonary embolism: a pharmacovigilance analysis. Expert Opin Drug Saf. 2025 Nov;24(11):1259-1264. doi: 10.1080/14740338.2024.2396390. Epub 2024 Aug 27. PMID: 39176419.
Liu Y, Xu J, Fang K, Xu Y, Gao J, Zhou C, Tang X, Fang X, Chen J, Xie C, Zhang F, Zhang X, Wang C. Current antipsychotic agent use and risk of venous thromboembolism and pulmonary embolism: a systematic review and meta-analysis of observational studies. Ther Adv Psychopharmacol. 2021 Jan 14;11:2045125320982720. doi: 10.1177/2045125320982720. PMID: 33505665; PMCID: PMC7812411. Yan Y, Wang L,
Yuan Y, Xu J, Chen Y, Wu B. A pharmacovigilance study of the association between antipsychotic drugs and venous thromboembolism based on Food and Drug Administration Adverse Event Reporting System data. Expert Opin Drug Saf. 2024 Jun;23(6):771-776. doi: 10.1080/14740338.2023.2251881. Epub 2023 Aug 30. PMID: 37615268.
