Haematological adverse effects associated with olanzapine in adolescents with anorexia nervosa: Three case reports

Elard Bottoni-Tito, Wendy Messa-Aguilar
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Abstract

Objectives

To describe haematological adverse effects in adolescents with anorexia nervosa who are taking olanzapine.

Methods

Case series report.

Case report

The reported cases (two female patients and one male) were found to have blood test abnormalities after starting olanzapine and to rapidly recover their platelet and neutrophil values after the drug was discontinued. Low haemoglobin values persisted longer than observed in other series. These abnormalities became more noticeable when the dose of olanzapine was increased to 5 mg/day (initial dose 2.5 mg/day). It should be noted that two of the patients already had values indicative of mild neutropenia before they started the antipsychotic drug, and that these worsened as they continued taking the drug. In one of the patients there was only a decrease in neutrophil values, as well as mild anaemia.

Conclusions

This first case series of haematological abnormalities in adolescents with anorexia nervosa who are taking olanzapine found values corresponding to pancytopenia in two of the three cases reported. It would be worthwhile to consider heightening haematological surveillance in this population when starting treatment with olanzapine and rethinking our knowledge regarding the frequency of these side effects.

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神经性厌食症青少年使用奥氮平引起的血液学不良反应:三份病例报告。
病例报告报告的病例(两名女性患者和一名男性患者)在开始服用奥氮平后发现血液检测异常,停药后血小板和中性粒细胞值迅速恢复。低血红蛋白值持续的时间比其他系列观察到的要长。当奥氮平的剂量增加到 5 毫克/天(初始剂量为 2.5 毫克/天)时,这些异常现象变得更加明显。值得注意的是,其中两名患者在开始服用抗精神病药物之前就已经出现了轻度中性粒细胞减少症的症状,而随着他们继续服药,这些症状又有所加重。结论这是首个关于服用奥氮平的神经性厌食症青少年血液学异常的病例系列,在报告的三个病例中,有两个病例的数值与全血细胞减少症相符。值得考虑的是,在开始使用奥氮平治疗时加强对这一人群的血液监测,并重新思考我们对这些副作用发生频率的认识。
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