{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T06:40:01Z","timestamp":1756363201916,"version":"3.44.0"},"reference-count":19,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2018,11,1]],"date-time":"2018-11-01T00:00:00Z","timestamp":1541030400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.bmj.com\/company\/legal-information\/terms-conditions\/legal-information\/tdm-licencepolicy"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2018,10,29]]},"published-print":{"date-parts":[[2018,11]]},"abstract":"<jats:p>Neuroleptic malignant-like syndrome is a rare but potentially fatal complication of sudden withdrawal of dopaminergic drugs. Clinical features are similar to that of neuroleptic malignant syndrome (NMS) like hyperthermia, autonomic dysfunction, altered sensorium, muscle rigidity; but instead of history of neuroleptic use, there is history of withdrawal of dopaminergic drugs. Laboratory examination generally show elevated creatine phosphokinase levels and may show elevated total leucocyte count. Thrombocytopaenia has been very rarely reported with NMS but it has not been reported with NM-like syndrome. Here, we discuss a case of Parkinson\u2019s disease which presented with typical clinical features and risk factors of NM-like syndrome associated with thrombocytopaenia and type 1 respiratory failure. He was treated with bromocriptine and supportive care. Thrombocytopaenia and respiratory failure resolved with above treatment. The patient improved clinically and was successfully discharged on day 12 of admission.<\/jats:p>","DOI":"10.1136\/bcr-2018-227089","type":"journal-article","created":{"date-parts":[[2018,12,18]],"date-time":"2018-12-18T17:19:47Z","timestamp":1545153587000},"page":"bcr-2018-227089","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Neuroleptic malignant-like syndrome causing thrombocytopaenia: a rare association"],"prefix":"10.1136","volume":"11","author":[{"given":"Harsh","family":"Sahu","sequence":"first","affiliation":[{"name":"Medicine, All India Institute of Medical Sciences, New Delhi, Delhi, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mouna Bidarguppe","family":"Manjunath","sequence":"additional","affiliation":[{"name":"Medicine, All India Institute of Medical Sciences, New Delhi, Delhi, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7498-9112","authenticated-orcid":false,"given":"Animesh","family":"Ray","sequence":"additional","affiliation":[{"name":"Medicine, All India Institute of Medical Sciences, New Delhi, Delhi, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Naval Kishore","family":"Vikram","sequence":"additional","affiliation":[{"name":"Medicine, All India Institute of Medical Sciences, New Delhi, Delhi, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2018,12,3]]},"reference":[{"key":"2025082723202073000_11.1.bcr-2018-227089.1","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1097\/PRA.0000000000000237","article-title":"The role of amantadine withdrawal in 3 cases of treatment-refractory altered mental status","volume":"23","author":"Fryml","year":"2017","journal-title":"J Psychiatr Pract"},{"key":"2025082723202073000_11.1.bcr-2018-227089.2","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1016\/j.genhosppsych.2010.11.013","article-title":"Neuroleptic malignant syndrome associated with bromocriptine withdrawal in Parkinson\u2019s disease-a case report","volume":"33","author":"WU","year":"2011","journal-title":"Gen Hosp Psychiatry"},{"key":"2025082723202073000_11.1.bcr-2018-227089.3","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1016\/S1353-8020(02)00035-4","article-title":"Neuroleptic malignant syndrome-like, or--dopaminergic malignant syndrome--due to levodopa therapy withdrawal. 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