Labs in NMS

Q: A low serum iron in Neuroleptic Malignant Syndrome (NMS) is (select one) 

A) sensitive marker 

B) specific marker 

 

Answer: A 

NMS is a life-threatening neurologic emergency. It requires a very high level of suspicion. Failure to recognize NMS carries high mortality. It is a clinical diagnosis although some lab abnormalities are associated with it, including: 

• high CPK
• high WBC
• high LDH
• high LFT
• low calcium
• low magnesium 
• high or low sodium
• high potassium 
• metabolic acidosis 
• rhabdomyolysis, myoglobinuria, and acute renal failure

Low serum iron is common in NMS. It is an extremely sensitive marker but is not very specific.

#neurology

References:

1. Lee JW. Serum iron in catatonia and neuroleptic malignant syndrome. Biol Psychiatry 1998; 44:499. 

2.Modi S, Dharaiya D, Schultz L, Varelas P. Neuroleptic Malignant Syndrome: Complications, Outcomes, and Mortality. Neurocrit Care 2016; 24:97.