Objective: The aim of this study was to report fever and syndrome of inappropriate antidiuretic hormone secretion induced by duloxetine intake in patient with multiple system atrophy.

Background: Multiple system atrophy (MSA) is a neurodegenerative disease mainly involving extrapyramidal system, cerebellum and autonomic nervous system, while hypothalamus is affected with different degree. Duloxetine was prescribed for chronic pain as a dual inhibitor of 5-HT and norepinephrine reuptake, with fever or SIADH as rare side effects.

Method: Clinical observations and analysis of serum sodium and body temperature were used before and after duloxetine

Results: The use of duloxetine resulted in increased body temperature and decreased blood sodium in patient with multisystem atrophy, which gradually improved after withdrawal.

Conclusion: We report on this rare case. In addition to considering infectious, tumor and autoimmune diseases in MSA patients, drug factors cannot be ignored. For MSA patients with suspected hypothalamic involvement, when low blood sodium, laryngeal stridor and others occur, drugs that burden the hypothalamus should be used carefully, such as duloxetine.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/fever-and-syndrome-of-inappropriate-antidiuretic-hormone-secretion-induced-by-duloxetine-intake-in-patient-with-multiple-system-atrophy/