Massive Assymptomatic Creatine Kinase Elevation with Quetiapine – A Case Report

Abstract

Context: With the growth of antipsychotic prescription in children and adolescents, it is paramount the adequate monitoring of clinical and analytical parameters. A syndrome of massive creatine kinase elevation has gained attention in the literature in the last decade, with many clinical reports in adults and adolescents with psychotic disorders and under antipsychotic treatment. However, clinical descriptions of this syndrome in adolescents with non-psychotic disorders are still very scarce. Case Report: We describe the clinical case of a 14-year-old girl with a depressive disorder, with no history of psychotropic medication, who developed a massive creatine kinase elevation syndrome upon administration of quetiapine. We explain the diagnostic pathway and the clinical management of the case. Conclusion: This case reflects the need of a greater attention regarding the rare, but clinically relevant syndrome of massive creatine kinase elevation. This recognition will probably lead to a lowering of unnecessary diagnoses of rhabdomyolisis or neuroleptic malignant syndromes in child and adolescent psychiatry practice.