scholarly journals Massive Assymptomatic Creatine Kinase Elevation with Quetiapine – A Case Report

2018 ◽  
Vol 3 (4) ◽  
Keyword(s):  
Creatine Kinase ◽  
Case Report ◽  
Depressive Disorder ◽  
Adolescent Psychiatry ◽  
Clinical Case ◽  
Psychotic Disorders ◽  
Child And Adolescent Psychiatry ◽  
Antipsychotic Treatment ◽  
Diagnostic Pathway ◽  
History Of

Context: With the growth of antipsychotic prescription in children and adolescents, it is paramount the adequate monitoring of clinical and analytical parameters. A syndrome of massive creatine kinase elevation has gained attention in the literature in the last decade, with many clinical reports in adults and adolescents with psychotic disorders and under antipsychotic treatment. However, clinical descriptions of this syndrome in adolescents with non-psychotic disorders are still very scarce. Case Report: We describe the clinical case of a 14-year-old girl with a depressive disorder, with no history of psychotropic medication, who developed a massive creatine kinase elevation syndrome upon administration of quetiapine. We explain the diagnostic pathway and the clinical management of the case. Conclusion: This case reflects the need of a greater attention regarding the rare, but clinically relevant syndrome of massive creatine kinase elevation. This recognition will probably lead to a lowering of unnecessary diagnoses of rhabdomyolisis or neuroleptic malignant syndromes in child and adolescent psychiatry practice.

scholarly journals S206. ARIPIPRAZOLE LONG-ACTING INJECTABLE IN SCHIZOPHRENIA DURING PREGNANCY: A CASE REPORT

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S117-S117
Author(s):  
Eva Sole ◽  
Juan Ignacio Duran ◽  
Sara Lera ◽  
Anna Torres ◽  
Susana Andres ◽  
...  
Keyword(s):  
Case Report ◽  
Mental Disorder ◽  
Clinical Case ◽  
Psychotic Disorders ◽  
Hospital Admissions ◽  
Treatment Compliance ◽  
Antipsychotic Treatment ◽  
Pregnancy And Postpartum ◽  
Long Acting ◽  
Psychiatric Complications

Abstract Background Long-acting injectable (LAI) antipsychotics provide some advantages in treatment compliance of psychotic disorders. However, information about their effects during pregnancy is still very limited. We expose a clinical case of aripiprazole LAI use in a pregnant woman diagnosed of schizophrenia. Methods A non-systematic review using Pubmed was conducted using the following terms: schizophrenia, pregnancy, aripiprazole and aripiprazole LAI. A clinical record review was performed for the clinical case report. Results We report the case of a 30-year-old woman diagnosed of schizophrenia. She required several hospital admissions in the past because of the mental disorder and the lack of treatment adherence, what was the consequence of having no insight of illness and her pregnancy desires. She was initially treated with risperidone, suffering from some adverse effects like prolactine elevation and amenorrhea. In the last hospital admission, she started treatment with aripiprazol 20mg, having a good tolerability and being finally changed into aripiprazole LAI 400mg/28days. No incidences were reported and stability was achieved. After five months, she became pregnant and started being followed up in the Perinatal Mental Health Unit that belongs to the same hospital. The severity of the mental disorder and her stability at that moment made psychiatrists; obstetricians and patient decide to keep the antipsychotic treatment with subsequent appointments. The goal was to supervise psychopathology and blood tests during pregnancy. Prolactine was in physiologic levels and there were no obstetric complications. She finally delivered at 41 gestational weeks to a 3465g baby girl (Apgar 1’: 9 Apgar 5’: 10). No neonatal complications were reported. The Stafford interview was also administered in order to explore her social, obstetric and psychological background as well as possible psychiatric complications due to pregnancy and puerperium. No psychiatric complications were reported. Postpartum Bounding Questionnaire was also administered. No bounding disorder was detected. Discussion Pregnancy and postpartum are periods that carry a high risk of illness onset or recurrence in women with severe mental disorders, such as schizophrenia. Having a good control of the symptoms may prevent from risks to both patient and child, due to the important influence that exists on the development of the baby and the mother-infant relationship.

Predictors of Suicidal Events

2018 ◽  
Author(s):  
Michael Maksimowski ◽  
Zheala Qayyum
Keyword(s):  
Study Design ◽  
Adolescent Psychiatry ◽  
Psychiatric Illness ◽  
Clinical Case ◽  
Suicide Attempts ◽  
Child And Adolescent Psychiatry ◽  
History Of ◽  
Study Intervention ◽  
Landmark Study

This chapter provides a summary of a landmark study in child and adolescent psychiatry. Youths with a history of psychiatric illness are known to be at greater risk of suicide. What are the predictors of suicidal events and attempts in adolescents with a history of suicide attempts and depression? Starting with that question, it describes the basics of the study, including funding, study location, who was studied, how many patients, study design, study intervention, follow-up, endpoints, results, and criticism and limitations. Several characteristics were identified that correlated with subsequent suicidal events. The chapter briefly reviews other relevant studies and information, discusses implications, and concludes with a relevant clinical case.

scholarly journals The effect of spinach-derived thylakoids on anthropometric parameters and metabolic profile in antipsychotic treatment: A case report

2021 ◽  
Vol 9 (8) ◽  
Author(s):  
Kajsa Lycken ◽  
Charlotte Albertsson
Keyword(s):  
Body Weight ◽  
Case Report ◽  
Side Effects ◽  
Adverse Effects ◽  
Psychotic Disorders ◽  
Lifestyle Changes ◽  
Antipsychotic Treatment ◽  
Safe Treatment ◽  
Metabolic Side Effects ◽  
History Of

Background: Antipsychotics is the first line, evidence-based treatment of schizophrenia and other primary psychotic disorders. Metabolic adverse effects are common, including body weight gain, hypertension and metabolic syndrome. There is still no safe treatment for these adverse effects, except from lifestyle changes. Studies of thylakoids have shown body weight loss and improved metabolic parameters in overweight women. Case report: A 53-year old female with a history of unspecified nonorganic psychosis, treated with Quetiapin and Topimax (Topiramat), was given a supplement of 5g thylakoids daily for 12 weeks. She reported a rapid decrease of sweet craving and loss of body weight was observed. Conclusion: We report a successful treatment with thylakoid supplements of the metabolic side effects of antipsychotics in a female adult with a history of body weight problems and sweet craving. Further investigation and larger studies are needed. A safe treatment of metabolic side effects could increase quality of life for patients in need of antipsychotic treatment.

Cycloid Psychosis: A Case Report

2016 ◽  
Vol 33 (S1) ◽  
pp. S532-S532
Author(s):  
G. Martinez-Ales ◽  
I. Louzao ◽  
A. Irimia ◽  
M.F. Bravo ◽  
J. Marin
Keyword(s):  
Case Report ◽  
Psychotic Disorders ◽  
Clinical History ◽  
Diagnostic Systems ◽  
Cycloid Psychosis ◽  
History Of ◽  
Competing Interest ◽  
High Index Of Suspicion ◽  
Clinical Pictures ◽  
Restitutio Ad Integrum

IntroductionEpisodes of time-limited acute psychosis, with full recovery in between, are categorized as acute polymorphic psychotic or brief psychotic disorders. Leonhard described the three forms of cycloid psychosis (CP). Perry considers it a separate entity.Case reportWe report the case of a 54-year-old male, with a 9-year history of brief psychotic disorders. He was admitted to an inpatient unit after a 4-day episode of persecutory delusion, leading to high emotional repercussions and isolation at home. Euthymia was present. Previous admissions, 9 and 5 years before, presented similar clinical pictures. Treatment with low dose paliperidone during 6-month periods had led to the complete resolution of the episodes (restitutio ad integrum: no psychotic manifestations and the ability to run his business). In this episode, 8 days after the reintroduction of 12 mg of paliperidone per day, cessation of the symptoms took place. Careful reconstruction of the clinical history showed no stressors or drug consumption. And immediately previous 5-day phase of insomnia, hyperactivity and expenditure was described by the patient's wife.DiscussionThree inpatient admissions, a careful clinical history and a thorough review of the evidence regarding Perris criteria led to a diagnosis of CP.ConclusionCP, a classical nosological approach, is helpful in a clinical setting, as it might imply different prognosis and treatment. Recognition of CP, not included as an entity by the major diagnostic systems, requires a high index of suspicion.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Thrombosis in patients with myeloproliferative neoplasms. Case report

2021 ◽  
Vol 93 (7) ◽  
pp. 800-804
Author(s):  
Anait L. Melikyan ◽  
Irina N. Subortseva ◽  
Elena A. Gilyazitdinova ◽  
Tamara I. Koloshejnova ◽  
Kristina S. Shashkina ◽  
...  
Keyword(s):  
Case Report ◽  
Arterial Hypertension ◽  
Clinical Case ◽  
Myeloproliferative Neoplasms ◽  
Primary Myelofibrosis ◽  
Hemoglobin Level ◽  
History Of ◽  
Thrombotic Complications ◽  
Acquired Thrombophilia ◽  
Significant Factors

Thrombotic complications are the most significant factors determining the prognosis in myeloproliferative neoplasms. Markers for assessing the risk of thrombosis are the number of leukocytes, platelets, hemoglobin level, hematocrit, age, molecular status, history of thrombosis, obesity, arterial hypertension, hyperlipidemia, hereditary or acquired thrombophilia. The pathogenesis of thrombosis in patients with myeloproliferative neoplasms is complex and multifactorial. In most cases, the etiological factor remains unknown. Currently, antiplatelet and anticoagulant therapy is carried out on an individual basis. The algorithm for primary and secondary (after thrombosis) prevention requires development and testing. We present a clinical case of repeated arterial and venous thrombotic complications in a patient with primary myelofibrosis.

scholarly journals Occult insulinoma after oesophagectomy for oesophageal cancer-diagnostic challenges

2021 ◽  
Vol 9 (1) ◽  
pp. 185
Author(s):  
Marta Alexandre Silva ◽  
Maria João Amaral ◽  
Pedro Pinto ◽  
Mónica Martins ◽  
Marco Serôdio ◽  
...  
Keyword(s):  
Case Report ◽  
Male Patient ◽  
Clinical Case ◽  
Gastrointestinal Surgery ◽  
Gastric Surgery ◽  
Diagnostic Investigation ◽  
Post Operative Period ◽  
History Of ◽  
Oesophageal Surgery ◽  
Hyperinsulinemic Hypoglycaemia

Hypoglycaemia in the post-operative period is mainly iatrogenic (related to anti-hyperglycaemic drugs), but can be explained by an endogenous hyperinsulinemic state. In the context of previous gastrointestinal surgery, a form of dumping syndrome can mask hypoglycaemia from an underlying cause, such as an insulinoma. The authors present a clinical case of a male patient who underwent oesophageal surgery for an oesophago-gastric junction adenocarcinoma and developed hypoglycaemic symptoms in the post-operative period, caused by an undiagnosed insulinoma. This case report portraits the diagnostic investigation of a hypoglycaemia state in the post-operative period, narrowing to the workup of an endogenous hyperinsulinemic hypoglycaemia and provides a summary of insulinoma’s treatment. An insulinoma should always be considered in a patient with endogenous hyperinsulinemic hypoglycaemia, even with a history of oesophago-gastric surgery.

scholarly journals Typical features of Parkinson disease and diagnostic challenges with microdeletion 22q11.2

Neurology ◽  
2018 ◽  
Vol 90 (23) ◽  
pp. e2059-e2067 ◽  
Author(s):  
Erik Boot ◽  
Nancy J. Butcher ◽  
Sean Udow ◽  
Connie Marras ◽  
Kin Y. Mok ◽  
...  
Keyword(s):  
Parkinson Disease ◽  
Psychotic Disorders ◽  
Age At Onset ◽  
22Q11.2 Deletion Syndrome ◽  
Motor Symptom ◽  
Deletion Syndrome ◽  
Antipsychotic Treatment ◽  
History Of ◽  
Microdeletion 22Q11.2

ObjectiveTo delineate the natural history, diagnosis, and treatment response of Parkinson disease (PD) in individuals with 22q11.2 deletion syndrome (22q11.2DS), and to determine if these patients differ from those with idiopathic PD.MethodsIn this international observational study, we characterized the clinical and neuroimaging features of 45 individuals with 22q11.2DS and PD (mean follow-up 7.5 ± 4.1 years).Results22q11.2DS PD had a typical male excess (32 male, 71.1%), presentation and progression of hallmark motor symptoms, reduced striatal dopamine transporter binding with molecular imaging, and initial positive response to levodopa (93.3%). Mean age at motor symptom onset was relatively young (39.5 ± 8.5 years); 71.4% of cases had early-onset PD (<45 years). Despite having a similar age at onset, the diagnosis of PD was delayed in patients with a history of antipsychotic treatment compared with antipsychotic-naive patients (median 5 vs 1 year, p = 0.001). Preexisting psychotic disorders (24.5%) and mood or anxiety disorders (31.1%) were common, as were early dystonia (19.4%) and a history of seizures (33.3%).ConclusionsMajor clinical characteristics and response to standard treatments appear comparable in 22q11.2DS-associated PD to those in idiopathic PD, although the average age at onset is earlier. Importantly, treatment of preexisting psychotic illness may delay diagnosis of PD in 22q11.DS patients. An index of suspicion and vigilance for complex comorbidity may assist in identifying patients to prioritize for genetic testing.

Initial Treatment of Bipolar I Disorder in Children and Adolescents

2018 ◽  
Author(s):  
Stephanie Ng ◽  
Andres Martin
Keyword(s):  
Children And Adolescents ◽  
Adolescent Psychiatry ◽  
Initial Treatment ◽  
Clinical Case ◽  
Child And Adolescent Psychiatry ◽  
Divalproex Sodium ◽  
Bipolar I Disorder ◽  
Study Intervention ◽  
Landmark Study

This chapter provides a summary of a landmark study in child and adolescent psychiatry. In medication-naïve children and adolescents with bipolar I disorder who have had a recent manic or mixed phase episode, should risperidone, lithium, or divalproex sodium be used for initial treatment? Also, for partial responders or nonresponders to the first medication, which agent should be added on or switched to? Starting with these questions, it describes the basics of the study, including funding, study location, who was studied, how many patients, study design, study intervention, follow-up, endpoints, results, and criticism and limitations. The chapter briefly reviews other relevant studies and information, discusses implications, and concludes with a relevant clinical case.

Is there a case for ‘unidisciplinary working’ in child psychiatry?

1992 ◽  
Vol 16 (01) ◽  
pp. 34-35 ◽  
Author(s):  
W. R. Silveira ◽  
C. G. Ballard ◽  
R. N. C. Mohan ◽  
L. McGibben ◽  
A. Sheikh ◽  
...  
Keyword(s):  
Child Psychiatry ◽  
Royal College ◽  
Adolescent Psychiatry ◽  
Multidisciplinary Team ◽  
Child And Adolescent Psychiatry ◽  
The Other ◽  
Working Model ◽  
Multidisciplinary Working ◽  
History Of ◽  
Model Of Practice

In many parts of the country, child psychiatrists currently provide services on their own. This ‘unidisciplinary’ model of practice is out of step with College recommendations for multidisciplinary working in child and adolescent psychiatry (Royal College of Psychiatrists, 1990). The question arises whether one model is in fact superior to the other. In this article we look briefly at the history of the multidisciplinary team, describe our own experience of providing a unidisciplinary service and suggest a working model for the future.

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