Can Neutrophil-lymphocyte Ratio Be a Useful Criterion for Neuroleptic Malignant Syndrome in the Absence of Leukocytosis?

Tevfik   Kalelioglu; Guler   Celikel; Ozlem   Devrim Balaban; Nesrin  Karamustafalioglu; Jennifer   Kim Penberthy

doi:10.18502/ijps.v16i3.6264

Tevfik Kalelioglu Department of Psychiatry and Neurobehavioral Sciences, University of Virginia, Charlottesville, Virginia, United States of America.
Guler Celikel Department of Psychiatry, Bakırköy Mental Health Research and Teaching Hospital, Istanbul, Turkey.
Ozlem Devrim Balaban Department of Psychiatry, Bakırköy Mental Health Research and Teaching Hospital, Istanbul, Turkey.
Nesrin Karamustafalioglu Department of Psychiatry, Bakırköy Mental Health Research and Teaching Hospital, Istanbul, Turkey.
Jennifer Kim Penberthy Department of Psychiatry and Neurobehavioral Sciences, University of Virginia, Charlottesville, Virginia, United States of America

DOI: https://doi.org/10.18502/ijps.v16i3.6264

Keywords: Antipsychotic Agents; Inflammation; Lymphocyte; Neuroleptic Malignant Syndrome; Neutrophil

Abstract

Objective: Neuroleptic malignant syndrome (NMS) is a rare but severe side effect of antipsychotic medication. Neutrophil-lymphocyte ratio (NLR) is a simple marker used to measure systemic inflammation.

Method: In this case report we explore the relationship of inflammation in the etiology of NMS. In our case involving NMS, although there was no leukocytosis, the NLR was increased up to systemic infection levels.

Conclusion: We hypothesized that systemic inflammation may take a role in developing NMS. If so, NLR could be a new marker of NMS that may be able to provide more sensitive results than leukocyte levels.