Sunday, March 21, 2021

Labs in NMS

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

A) sensitive marker 
B) specific marker 


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.



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.

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