The Neuroleptic Malignant Syndrome and Acute Renal Failure

Neuroleptic malignant syndrome is characterized by the development of muscle rigidity, altered consciousness and hyperthermia during the administration of neuroleptics or the withdrawal of dopaminergic agents. Rhabdomyolysis is a clinical phenomenon arising from skeletal muscle injury. Many patients suffering from myoglobinuric renal failure present with asymptomatic rhabdomyolysis from elevations in serum creatine phosphokinase (CPK). In this article, we review a case of drug-induced rhabdomyolysis with renal failure in a patient with the neuroleptic malignant syndrome (NMS). We address the significant clinical features of NMS, the spectrum of differential diagnosis and its pathophysiology. The association between NMS and renal failure and various therapies for this potentially fatal drug reaction are discussed.