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06 May 2022: Articles

Neuroleptic Malignant Syndrome with Adrenal Insufficiency After BNT162b2 COVID-19 Vaccination in a Man Taking Valproate: A Case Report

Unusual clinical course, Unexpected drug reaction

Tomohito Mizuno A , Riku Takahashi B , Takahiro Kamiyama B , Atsushi Suzuki D* , Masashi Suzuki A

DOI: 10.12659/AJCR.936217

Am J Case Rep 2022; 23:e936217

Table 1. Laboratory data of the patient.

First hospital daySecond hospital day
Creatine kinase (U/L)13383191
Lactate dehydrogenase (U/L)311345
Aspartate aminotransferase (U/L)89139
Alanine aminotransferase (U/L)3650
Alkaline phosphatase (U/L)4341
Total bilirubin (mg/dL)0.7
Blood urea nitrogen (mg/dL)4548
Serum creatinine (mg/dL)6.155.68
Estimated GFR (ml/min/1.73 m)8.89.6
Serum sodium (mEq/L)137135
Serum potassium (mEq/L)4.73.5
Serum chloride (mEq/L)99100
Serum calcium (mg/dL)9.7
Serum phosphorus (mg/dL)2.0
Serum albumin (g/dL)3.22.9
C-reactive protein (mg/dL)19.721.8
Antinuclear antibody (titer)1: 40
MPO-ANCA (U/mL)< 1.0
PR3-ANCA (U/mL)< 1.0
White blood cell (/µL)86106150
Neutrophil (%)52.475.0
Lymphocyte (%)27.89.3
Monocyte (%)16.310.2
Eosinophil (%)3.05.0
Red blood cell (/µL)356×10332×10
Hemoglobin (g/dL)11.210.3
Hematocrit (%)31.329.7
Platelet (/µL)16.1×1014.1×10
GFR – glomerular filtration rate; MPO-ANCA – myeloperoxidase-anti-neutrophil cytoplasmic antibodies; PR3-ANCA – proteinase-3-anti-neutrophil cytoplasmic antibodies.

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American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923