Rhabdomyolysis associated with olanzapine treatment in a child with Autism

Area of Science:

• Pediatric neurology
• Autism spectrum disorder treatment
• Pharmacovigilance

Background:

• Autism spectrum disorder (ASD) is frequently associated with challenging behaviors.
• Olanzapine is an atypical antipsychotic increasingly used to manage behavioral disturbances in children with ASD.
• Common side effects include weight gain and sedation, while serious adverse events are rare.

Observation:

• A case of rhabdomyolysis is reported in a child with autism shortly after initiating olanzapine therapy.
• The patient presented with extremely elevated creatine kinase levels (30,690 IU/L) after only two doses.
• Rhabdomyolysis is a rare but serious potential adverse effect of olanzapine.

Findings:

• The autistic child's rhabdomyolysis resolved within 7 days with supportive care, including hydration and alkalinization.
• This case underscores the potential for rare, severe adverse reactions to olanzapine in pediatric populations.
• Serum creatine kinase monitoring may be a valuable tool for early detection of muscle injury.

Implications:

• Clinicians should be aware of the rare risk of rhabdomyolysis when prescribing olanzapine to children with autism.
• Close monitoring of creatine kinase levels may be warranted upon initiation of olanzapine treatment in this vulnerable population.
• Further research into the mechanisms and risk factors for olanzapine-induced rhabdomyolysis in pediatric ASD is needed.