ABSTRACT
BACKGROUND: Electroconvulsive therapy (ECT) is a safe treatment for treatment-resistant schizophrenia. However, it has some side effects, and Takotsubo cardiomyopathy is considered one of the minor complications. Several cases of patients developing Takotsubo cardiomyopathy during a course of ECT have been reported, but none have died. We present a case of post-ECT Takotsubo cardiomyopathy that became fatal. CASE PRESENTATION: We experienced a case of a 67-year-old woman who had delusions and catatonic symptoms due to schizophrenia but was resistant to several medications. Her symptoms improved by conducting ECT, but she had difficulty maintaining her improvement, which caused her to receive multiple courses of ECT. 3 weeks after her 6th course of ECT, the patient was diagnosed with Takotsubo cardiomyopathy and had a fatal outcome. CONCLUSION: Our patient had numerous cases of aspiration pneumonia and malnutrition before ECT was performed, which might have made this case fatal. In conclusion, appropriate supplementation of nutrition and reduction of physical stressors are important to avoid death from Takotsubo cardiomyopathy caused by ECT. Prescribing clozapine was a solution in the present case, but there are some difficulties, such as the restriction against prescribing this drug in Japan.
Subject(s)
Catatonia , Electroconvulsive Therapy , Schizophrenia , Takotsubo Cardiomyopathy , Humans , Female , Aged , Electroconvulsive Therapy/adverse effects , Schizophrenia/complications , Schizophrenia/therapy , Takotsubo Cardiomyopathy/etiology , Takotsubo Cardiomyopathy/therapy , Catatonia/complications , Japan , Treatment OutcomeABSTRACT
Distinction of intergeneric hybrids between Argyranthemum frutescens (L.) Sch. Bip. and Rhodanthemum gayanum (Cross. & Durieu) B.H. Wilcox, K. Bremer & Humphries is important for the development of new intergeneric hybrids. The aim of this study was to develop a simple and cost-effective DNA marker to distinguish between a large number of putative hybrids of A. frutescens × R. gayanum during primary selection. We designed sequence-characterized amplified region (SCAR) markers based on the genetic sequences of the internal transcribed spacer (ITS) region for A. frutescens and R. gayanum. Specific SCAR markers for A. frutescens amplified bands in A. frutescens and hybrids but not in R. gayanum. In contrast, specific SCAR markers for R. gayanum amplified bands in R. gayanum and hybrids but not in A. frutescens. Additionally, we confirmed the reproducibility of the SCAR marker using 31 cultivars. The findings demonstrated that these SCAR markers could be used to distinguish putative hybrids between A. frutescens and R. gayanum. This is the first report of the development of a SCAR marker to facilitate distinction of these hybrids.
