Check also his plasma urate to exclude acute-on-chronic
renal failure due to partial Lesch Nyhan Syndrome. Also
exclude methy-lmalonate: recent (unpublished) adult case
here.
----------------------
Dr John A Duley
Purine Research Laboratory
Guy's Hospital
London SE1 9RT (GB)
---------------------
On Mon, 28 Jan 2002 16:05:30 -0000 "Hyde Philip (ULHT)"
<[log in to unmask]> wrote:
> We admitted a 31 yr old male on 24th January. He has schizophrenia and has
> been on fluoxetine for 2 yrs followed by more recently 3 months-worth of
> risperidone. His admission renal profile was as follows:
> Sodium 120 mmol/l, potassium 3.0 mmol/l, urea 22.5mmol/l, creatinine 1071
> umol/l. He had an ALT of 895 IU/l, with bilirubin 30 umol/l, GGT 74 IU/l and
> virtually normal clotting. Salicylate and paracetamol were both negative on
> admission.
> Today, 28th Jan, his creatinine is down to 550umol/l, urea 19.7 mmol/l and
> ALT 278.
> His renal function on 1/11/01 was entirely normal. The full history may not
> yet have emerged, but the severity of his renal failure was surprising to
> say the least (we don't have any other drug hostory). My question is : Does
> risperidone, or its combination with fluoxetine, have any known link with
> nephrotoxicity ? I can't see anything in BNF or on the SPIB web-site (except
> "Monitor electrolytes").
> Enlightenment welcomed,
>
> Philip Hyde,
> Clin Chem, Pilgrim Hospital, Boston (UK).
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