Clozapine is an atypical antipsychotic proven to be superior in the treatment of treatment-resistant schizophrenia. Myocarditis is a rare, but well-known complication of treatment with clozapine. Only few cases have been reported in which nausea and vomiting were prominent symptoms. This is the first described report in which nausea and vomiting were the only presenting symptoms of clozapine-induced myocarditis. We report a case of a 58-year-old woman, suffering from schizoaffective disorder, who is being treated with clozapine. Two weeks after initiation of clozapine, she developed nausea and vomiting, in absence of any other clinical symptoms. Laboratory examination and magnetic resonance imaging confirmed the diagnosis of clozapine-induced myocarditis. Clozapine was discontinued and the patient recovered fully. This case emphasizes the importance of recognizing myocarditis as a cause of isolated nausea and vomiting in patients treated with clozapine. Early recognition improves clinical outcome and reduces mortality.

中文翻译：

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氯氮平诱发的心肌炎的主要症状是孤立的恶心和呕吐：一例报告

氯氮平是一种非典型的抗精神病药物，在治疗难治性精神分裂症方面被证明具有优越性。心肌炎是氯氮平治疗的罕见但众所周知的并发症。仅报告了恶心和呕吐为突出症状的少数病例。这是首次描述的报告，其中恶心和呕吐是氯氮平诱发的心肌炎的唯一表现症状。我们报告了一名患有精神分裂症的58岁女性，正在接受氯氮平治疗。服用氯氮平后两周，在没有任何其他临床症状的情况下，她出现了恶心和呕吐。实验室检查和磁共振成像证实了氯氮平诱发的心肌炎的诊断。停用氯氮平，患者完全康复。该案例强调了接受氯氮平治疗的患者应将心肌炎识别为孤立的恶心和呕吐的原因。早期识别可改善临床结局并降低死亡率。