Mania as a presenting symptom of Wilson's disease

2006 ◽  
Vol 18 (1) ◽  
pp. 47-49 ◽  
Author(s):  
Prabhat Kumar Chand ◽  
Pratima Murthy
Keyword(s):  
Wilson’S Disease ◽  
Psychiatric Symptoms ◽  
Lithium Carbonate ◽  
Wilson's Disease ◽  
Extrapyramidal Symptoms ◽  
Psychiatric Clinic ◽  
Initial Examination ◽  
High Propensity ◽  
Neuroleptic Withdrawal ◽  
Rule Out

Objective:Wilson's disease commonly presents with neurological or hepatic manifestations. When it presents with only psychiatric symptoms, or with extrapyramidal symptoms secondary to neuroleptic exposure, the diagnosis of underlying Wilson's disease may be missed.Methods:An 18-year-old boy presented to the psychiatric clinic with a manic syndrome and high propensity for extrapyramidal symptoms to neuroleptic. Initial examination revealed splenomegaly and pancytopenia. Subsequent detection of Kayser–Fleischer ring and typical biochemical findings confirmed the diagnosis of Wilson's disease.Results:While the psychiatric symptoms came under control with lithium carbonate, extrapyramidal symptoms continue to persist even after neuroleptic withdrawal. Pancytopenia thought to be due to hypersplenism persists, and patient has developed features of liver cirrhosis. Treatment with zinc and folic acid has been started, and the patient is under evaluation for treatment with penicillamine.Conclusion:The psychiatrist needs to recognize that Wilson's disease can uncommonly present with isolated psychiatric symptoms, including mania. Early and severe extrapyramidal symptoms secondary to neuroleptic exposure in an adolescent age group warrants a detailed evaluation to rule out underlying neuropsychiatric conditions.

Extrapyramidal symptoms in Wilson's disease are associated with olfactory dysfunction

2006 ◽  
Vol 21 (9) ◽  
pp. 1311-1316 ◽  
Author(s):  
Antje Mueller ◽  
Ulrike Reuner ◽  
Basile Landis ◽  
Hagen Kitzler ◽  
Heinz Reichmann ◽  
...  
Keyword(s):  
Wilson’S Disease ◽  
Wilson's Disease ◽  
Olfactory Dysfunction ◽  
Extrapyramidal Symptoms

scholarly journals Resolved Psychosis after Liver Transplantation in a Patient with Wilson’s Disease

2011 ◽  
Vol 7 (1) ◽  
pp. 182-184 ◽  
Author(s):  
Orazio Sorbello ◽  
Daniela Riccio ◽  
Margherita Sini ◽  
Mauro Carta ◽  
Luigi Demelia
Keyword(s):  
Liver Transplantation ◽  
Liver Function ◽  
Wilson’S Disease ◽  
Psychiatric Symptoms ◽  
Copper Metabolism ◽  
Wilson's Disease ◽  
Hepatic Disease ◽  
Behavioral Symptoms ◽  
Psychiatric Disease ◽  
History Of

A psychiatric involvement is frequently present in Wilson’s disease. Psychiatric symptoms are sometimes the first and only manifestation of Wilson’s disease. More often a psychiatric involvement is present beside a neurologic or hepatic disease. We describe the case of a 18 years-old male patient who shows a clinic and laboratoristic pattern of cirrhosis and an history of subchronic hallucinatory psychosis, behavioral symptoms and mood disturbances with depressed mood. He hadn’t familiar history of liver or psychiatric disease. Laboratory and imaging tests confirmed the diagnosis of Wilson’s disease with psichiatric involvement. After liver transplantation copper metabolism and liver function normalised and we noticed no recurrency of the psichiatric illness. Very few cases of psychiatric improvement after orthotopic liver transplantation (OLT) has been described until now.

scholarly journals ATYPICAL MANIFESTATIONS OF ACUTE HEPATITIS IN ADOLESCENT AGE GROUP: MANDATORY TO RULE OUT WILSON’S DISEASE

2020 ◽  
Vol 06 (05) ◽  
pp. 227-228
Author(s):  
Fehmida Najmuddin ◽  
Keya Rani Lahiri ◽  
Anand Sude ◽  
Anshita Bansal ◽  
Manisha Reddy ◽  
...  
Keyword(s):  
Acute Hepatitis ◽  
Wilson’S Disease ◽  
Wilson's Disease ◽  
Age Group ◽  
Atypical Manifestations ◽  
Rule Out

scholarly journals Atypical case of Wilson's disease with psychotic onset, low 24 hour urine copper and the absence of Kayser-Fleischer rings

2014 ◽  
Vol 71 (12) ◽  
pp. 1155-1158 ◽  
Author(s):  
Dragan Krstic ◽  
Jadranka Antonijevic ◽  
Zeljko Spiric
Keyword(s):  
Genetic Analysis ◽  
Wilson’S Disease ◽  
Clinical Symptoms ◽  
Psychiatric Symptoms ◽  
Molecular Genetic ◽  
Signs And Symptoms ◽  
Wilson's Disease ◽  
Molecular Genetic Analysis ◽  
Laboratory Findings ◽  
Atypical Case

Introduction. Wilson's disease is typically manifested in two clinical forms, neurological and hepatic and in rare cases it starts with psychiatric symptoms exclusively. We presented a rare atypical case of Wilson's disease with psychotic onset. Case report. A 22-year-old male patient was initially presented with predominant signs and symptoms of psychiatric disorder and then later with the development of neurological signs and symptoms. Neuroimaging, detected metal deposits in central nervous system (CNS) but not in peripheral organs, while serum analysis excluded pantothenate-kinase associated neurodegeneration (PKAN) and aceruloplasminemia. In favor of the diagnosis of Wilson's disease there were reduced concentrations of copper and ceruloplasmin concentrations and metal deposits in CNS, but other pathognomonic signs and symptoms were absent: in-creased copper in urine, Kayser-Fleischer rings in Descemet?s corneal membrane and deposits of copper in liver. Introduction of penicillamine treatment resulted in improvement in mental and general health of the patient. Molecular genetic analysis definitely confirmed the diagnosis of Wilson's disease. Conclusion. Wilson's disease can remain undetected for a long period of time if masked with dominant or exclusive psychiatric symptoms. If clear clinical symptoms and signs, and unambiguous laboratory findings are not present, it is necessary to perform molecular genetic analysis to confirm the definitive diagnosis.

Wilson's disease and the neuroleptic malignant syndrome

1990 ◽  
Vol 7 (2) ◽  
pp. 138-139 ◽  
Author(s):  
Peter Buckley ◽  
Eamonn Carmody ◽  
Michael Hutchinson
Keyword(s):  
Neuroleptic Malignant Syndrome ◽  
Wilson’S Disease ◽  
Psychiatric Symptoms ◽  
Copper Metabolism ◽  
Wilson's Disease ◽  
Copper Deposition ◽  
Hepatolenticular Degeneration ◽  
Psychiatric Disturbance ◽  
Neuroleptic Medication ◽  
Wide Range

AbstractWilson's Disease (Hepatolenticular degeneration) is an uncommon disorder of copper metabolism, characterised by excessive copper deposition in the liver, brain and eyes. Psychiatric symptoms were prominent in eight of the twelve patients originally described by Wilson some 88 years ago. Since then a wide range of psychiatric presentations have been documented including behavioural disturbances, affective psychoses, schizophrenia-like psychoses, intellectual deterioration and dementia. Here we describe a patient who presented with a psychiatric disturbance, was treated with neuroleptic medication and subsequently developed Neuroleptic Malignant Syndrome (NMS).

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