Acute onset of ascites with clozapine-induced hepatitis.

摘要

A 43-year-old woman with known schizoaffective disorder was admitted for acute psychosis. Clozapine was initiated and increased to 300 mg daily over 2 weeks. She became febrile and tachycardic. An initial septic work-up including transthoracic echocardiogram showed nothing. On day 26 of her admission, she was febrile (38.6 deg C) with a pulse of 130 b.p.m., mild abdominal distension and tenderness. Electrocardiogram was normal. Chest radiograph showed a small right pleural effusion without cardiomegaly. Blood tests showed an eosinophilia of 7.9 X 10~9/L and hepatic liver function tests showed the following values: serum albumin 40 g/L, bilirubin. 10 mumol/L, gamma-glutamyltransferase 76 U/L, alkaline phos-phatase 132 U/L, aspartate aminotransferase 172 U/L and alanine aminotransferase 246 U/L).