MeSH The lack of recognition of these signs and symptoms as being attributable to WD often leads to delays in diagnosis and management. She had previous eleven admissions in psychiatric hospital with major depressive episode with psychotic features, schizoaffective disorders, and then schizophrenia diagnosis. Schizophrenia-like psychosis and delusional disorder are rare forms of psychiatric manifestations of WD. The oddness in this. After a week, tab penicillamine was increased to 500 mg/day, with which his psychiatric symptoms worsened. Wilson's disease (WD) is an autosomal-recessive disorder associated with copper metabolism that produces abnormal accumulation of copper in the liver, brain, kidneys, and other organs 1. [4,5] However, the prevalence of psychosis and catatonia is higher in patients with neurological manifestations of Wilson's disease.[6]. [Schizophrenia and Wilson's disease] - PubMed Find out more about saving to your Kindle. Copper accumulates in the liver, brain, eyes, and other organs. Bethesda, MD 20894, Web Policies Substance test result was negative. The psychiatric presentations of Wilson's disease. Mayo Clin Proc. It is well known for its role in the pathogenesis of Wilson disease and regulating iron metabolism. There was no family history of any psychiatric illness and developmental milestones were reportedly normal. Prashanth LK, Taly AB, Sinha S, Arunodaya GR, Swamy HS. Wilson's disease, also known as hepatolenticular degeneration and progressive lenticular degeneration, is a rare genetic disorder that causes copper poisoning in the body. Psychiatric symptoms in 195 cases. MeSH ABSTRACT McDonald LV, Lake CR. Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh, India, 1Department of Hepatology, Postgraduate Institute of Medical Education and Research, Chandigarh, India. [5] Symptoms may progress rapidly, especially in younger patients, but are more often gradual in development with periods of remission and exacerbation. Section 5. Unauthorized use of these marks is strictly prohibited. [ 1] Ocular and hepatic abnormalities are the most prominent non-neurologic manifestations of WD. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). government site. Schizophrenia is a serious mental disorder in which people interpret reality abnormally. In view of the clinical picture, a diagnosis of organic delusional disorder (F06.2) due to Wilson's disease was considered. Neuropsychiatric; Wilson disease; psychosis; psychosomatic; schizophrenia. Contact and Gysin WM, Cooke ET. Wilson's disease (WD) is an inherited autosomal recessive disorder that affects copper metabolism. The early manifestations were psychiatric symptoms and epileptic seizures with or without secondary generalization. On the basis of clinical manifestations and laboratory findings, a diagnosis of Wilson's disease was made. Since psychosis can be the manifestation of medical diseases such as WD, overall view of these patients is necessary and medical diseases should be considered as a differential diagnosis. Huang CC, Chu NS. Frontiers | Late-Onset Wilson's Disease 8600 Rockville Pike Wilson's disease is traditionally considered a disease of children and young adults. Abstract Wilson's disease (WD) or hepatolenticular degeneration is an inherited neurodegenerative disorder of copper metabolism (autosomal recessive, chromosome13). Chapter 27. However, the diagnosis of Wilson's disease was made after 12 years of the first episode of psychosis. Patients with primarily hepatic disease usually present earlier than those with neurological disease. [1] Also, ceruloplasmin is a positive acute-phase reactant, meaning its levels will increase in inflammatory conditions or cell injury. Epub 2007 Sep 5. Progressive lenticular degeneration: A familial nervous disease associated with cirrhosis of the liver. 2012;1:61. doi: 10.4103/2277-9175.100182. Progressive lenticular degeneration: A familial nervous disease associated with cirrhosis of liver. -. Epub 2013 Oct 9. Please confirm you are a human by completing the captcha challenge below. [43], Co-occurrence of schizophrenic-like symptoms with WD is rare, and there are just a few case reports of WD with this type of psychiatric presentation. Journals & 2012;8:102-9. doi: 10.2174/1745017901208010102. Disclaimer. Twelve years after his first psychiatric hospitalization, it was discovered that he was suffering from WD. She also complained of infrequently hearing voices that were commanding and persecutory in nature. A case report described the resolution of subchronic hallucinatory psychosis, behavioral symptoms and mood disturbances in a patient with Wilson's disease after liver transplantation. This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. At the first movement neurological symptoms were misinterpreted as side effect of haloperidol, but consulted neurologist suggested additional diagnostic procedure which confirmed WD. He had a developmental retardation in comparison with the others of his age and because of some behavioral problems and a decrease in his educational function he was expelled from school at the age of eighteen. Misidentification of Wilson Disease as Schizophrenia (1998 - PubMed Wilson disease and psychiatric symptoms: A brief case report. One week after the onset of the symptoms he was prescribed tab penicillamine, initially 250 mg/day, which was increased to 500 mg/day after 3 days. An 18 year-old male first presented a clinical picture of acute psychosis with two recurrences at ages 22 and 23. At the age of 17 years, the first set of severe psychiatric signs and symptoms surfaces, including negativism, commanding auditory hallucinations, persecutory delusions, and impaired verbal communication. sharing sensitive information, make sure youre on a federal Psychiatric disturbances as a first clinical symptom of Wilson's disease - case report. However, neuroleptics had to be continued because of the delay in diagnosing the illness, which diminished the efficiency of the single chelating treatment. Chapter 27 - Wilson's Disease from Section 3 - Organic syndromes of schizophrenia. Javed MA, Zia S, Ashraf S, Mehmood S. Neurological and neuropsychiatric spectrum of Wilson's disease in local population. Srinivas K, Sinha S, Taly AB, Prashanth LK, Arunodaya GR, Janardhana Reddy YC, et al. Dening TR, Berrios GE. Pathophysiology and treatment of Wilson's disease. In this report, the patient with WD presented by psychosis symptoms and treated mistaken as schizophrenia for almost ten years. Federal government websites often end in .gov or .mil. [The onset of psychiatric disorders and Wilson's disease]. and transmitted securely. The https:// ensures that you are connecting to the Population screening and diagnostic strategies in screening family members of Wilson's disease patients. "coreDisableEcommerceForArticlePurchase": false, conditionsPrivacy policy. Psychosis in an adolescent with Wilson's disease: A case report and review of the literature. Accessibility Epub 2007 Sep 27. official website and that any information you provide is encrypted Bethesda, MD 20894, Web Policies [4] WD is often accompanied by psychiatric manifestations, which may precede signs and symptoms indicating neurological deficit. Schizophrenia-like psychosis and delusional disorder are rare forms of psychiatric manifestations of WD. Before Bethesda, MD 20894, Web Policies support, Terms and The lack of recognition of these signs and symptoms as being attributable to WD often leads to delays in diagnosis and management. Federal government websites often end in .gov or .mil. The abnormal behavior led to the admission into the hepatology unit of the Institute, and psychiatric consultation was sought. Wilson disease is a rare genetic disorder found in children in which large amounts of copper build up in the liver and brain. official website and that any information you provide is encrypted Mcdonald L, Lake CR. Wilson's disease (WD) is a rare autosomal recessive disorder of hepatocellular copper deposition. Wilson's disease is a genetic disorder in which excess copper builds up in the body. [1,2] The most common psychiatric manifestations in patients with Wilson's disease include sudden and changeable mood swings, anger outbursts, personality changes, depression, anxiety and cognitive impairment. The hepatic presentation may be in the form of elevated transaminase levels, chronic hepatitis or cirrhosis; while neurological manifestations may be in the form of tremors, choreiform movements, dysarthria, gait disturbances, etc. Keywords: Bidaki R, Zarei M, Mirhosseini SM, Moghadami S, Hejrati M, Kohnavard M, Shariati B. Adv Biomed Res. Diagnosis of Wilson's disease: an experience over three decades Symptoms may progress rapidly, especially in younger patients, but are more often gradual in development with periods of remission and exacerbation. Akil M, Schwartz JA, Dutchak D, Yuzbasiyan-Gurkan V, Brewer GJ. Cardiac, neurological, hepatic and renal manifestations are well defined, nevertheless approximately 30% of patients debut with neuropsychiatric symptoms. [25] With regards to treatment of psychosis, two case reports described the use of electroconvulsive therapy in a patient with psychosis and Wilson's disease. Sorbello O, Riccio D, Sini M, Carta M, Demelia L. Resolved psychosis after liver transplantation in a patient with Wilson's disease. eCollection 2017. Penicillamine was administered by her main physician, a gastrointestinal specialist. Gen Hosp Psychiatry. Before Acute psychosis and Wilson's disease - Oxford Academic Early detection of WD is important to prevent catastrophic outcome. Wilson's disease (WD) is a rare, . Oder W, Grimm G, Kollegger H, Ferenci P, Schneider B, Deecke L. Neurological and neuropsychiatric spectrum of Wilson's disease: A prospective study of 45 cases. As mentioned in this report, co-occurrence of schizophrenic-like symptoms with WD is uncommon and there are just a few reports of the WD cases with psychiatric presentation. Jayaswal SK, Lal P, Nepal MK, Wig NN. Wilson's disease in a young girl with abnormal behavior. [40] Wolf found that patients with schizophrenia had serum copper levels that were increased by 24% and serum ceruloplasmin levels elevated by 20% compared to control group. Merle U, Schaefer M, Ferenci P, Stremmel W. Clinical presentation, diagnosis and long-term outcome of Wilson's disease: A cohort study. Genetic testing. Kaplan HI, Sadock BJ. Srinivas K, Sinha S, Taly AB, Prashanth LK, Arunodaya GR, Janardhana Reddy YC, Khanna S. J Neurol Sci. Progressive lenticular degeneration: A familial nervous disease associated with cirrhosis of liver. Huang C, Chu N. Psychosis and epileptic seizures in Wilson's disease with predominantly white matter lesions in the frontal lobe. The .gov means its official. and transmitted securely. Current treatments cannot fix the copper metabolism. Benhamla T, Tirouche YD, Abaoub-Germain A, Theodore F. Encephale. An official website of the United States government. [7] Schizophrenia-like psychosis and delusional disorder are rare forms of psychiatric manifestations of WD, and only a few cases have been reported in the literature. An interdisciplinary approach with good collaboration of psychiatrists and neurologists is crucial for WD because early diagnosis and management without delay is an important for good prognosis. Elsevier B.V. or its licensors or contributors.
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