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Case report: Psychosis and catatonia in an adolescent patient with adipsic hypernatremia and autoantibodies against the subfornical organ

This is the first description of a patient in which adipsic hypernatremia, a rare autoimmune encephalitis, presented in combination with complex psychiatric symptomatology, including psychosis and catatonia. Adipsic hypernatremia is characterized by autoantibodies against the thirst center of the br...

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Autores principales: Liebrand, Matthias, Rebsamen, Michael, Nakamura-Utsunomiya, Akari, von den Driesch, Luisa, Köck, Patrick, Caccia, Julien, Hamann, Christoph, Wiest, Roland, Kaess, Michael, Walther, Sebastian, Tschumi, Sibylle, Hiyama, Takeshi Y., Kindler, Jochen
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10396436/
https://www.ncbi.nlm.nih.gov/pubmed/37539324
http://dx.doi.org/10.3389/fpsyt.2023.1206226
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author Liebrand, Matthias
Rebsamen, Michael
Nakamura-Utsunomiya, Akari
von den Driesch, Luisa
Köck, Patrick
Caccia, Julien
Hamann, Christoph
Wiest, Roland
Kaess, Michael
Walther, Sebastian
Tschumi, Sibylle
Hiyama, Takeshi Y.
Kindler, Jochen
author_facet Liebrand, Matthias
Rebsamen, Michael
Nakamura-Utsunomiya, Akari
von den Driesch, Luisa
Köck, Patrick
Caccia, Julien
Hamann, Christoph
Wiest, Roland
Kaess, Michael
Walther, Sebastian
Tschumi, Sibylle
Hiyama, Takeshi Y.
Kindler, Jochen
author_sort Liebrand, Matthias
collection PubMed
description This is the first description of a patient in which adipsic hypernatremia, a rare autoimmune encephalitis, presented in combination with complex psychiatric symptomatology, including psychosis and catatonia. Adipsic hypernatremia is characterized by autoantibodies against the thirst center of the brain. These autoantibodies cause inflammation and apoptosis in key regions of water homeostasis, leading to lack of thirst and highly increased serum sodium. To date, the symptoms of weakness, fatigue and drowsiness have been associated with adipsic hypernatremia, but no psychiatric symptomatology. Here, we showcase the first description of an adolescent patient, in which severe and complex psychiatric symptoms presented along with adipsic hypernatremia. The patient experienced delusion, hallucinations, restlessness and pronounced depression. Further, he showed ritualized, aggressive, disinhibited and sexualized behavior, as well as self-harm and psychomotor symptoms. Due to his severe condition, he was hospitalized on the emergency unit of the child and adolescent psychiatry for 8 months. Key symptoms of the presented clinical picture are: childhood-onset complex and treatment-resistant psychosis/catatonia, pronounced behavioral problems, fatigue, absent thirst perception, hypernatremia and elevated prolactin levels. This case report renders first evidence speaking for a causal link between the autoimmune adipsic hypernatremia and the psychotic disorder. Moreover, it sheds light on a new form of autoimmune psychosis.
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spelling pubmed-103964362023-08-03 Case report: Psychosis and catatonia in an adolescent patient with adipsic hypernatremia and autoantibodies against the subfornical organ Liebrand, Matthias Rebsamen, Michael Nakamura-Utsunomiya, Akari von den Driesch, Luisa Köck, Patrick Caccia, Julien Hamann, Christoph Wiest, Roland Kaess, Michael Walther, Sebastian Tschumi, Sibylle Hiyama, Takeshi Y. Kindler, Jochen Front Psychiatry Psychiatry This is the first description of a patient in which adipsic hypernatremia, a rare autoimmune encephalitis, presented in combination with complex psychiatric symptomatology, including psychosis and catatonia. Adipsic hypernatremia is characterized by autoantibodies against the thirst center of the brain. These autoantibodies cause inflammation and apoptosis in key regions of water homeostasis, leading to lack of thirst and highly increased serum sodium. To date, the symptoms of weakness, fatigue and drowsiness have been associated with adipsic hypernatremia, but no psychiatric symptomatology. Here, we showcase the first description of an adolescent patient, in which severe and complex psychiatric symptoms presented along with adipsic hypernatremia. The patient experienced delusion, hallucinations, restlessness and pronounced depression. Further, he showed ritualized, aggressive, disinhibited and sexualized behavior, as well as self-harm and psychomotor symptoms. Due to his severe condition, he was hospitalized on the emergency unit of the child and adolescent psychiatry for 8 months. Key symptoms of the presented clinical picture are: childhood-onset complex and treatment-resistant psychosis/catatonia, pronounced behavioral problems, fatigue, absent thirst perception, hypernatremia and elevated prolactin levels. This case report renders first evidence speaking for a causal link between the autoimmune adipsic hypernatremia and the psychotic disorder. Moreover, it sheds light on a new form of autoimmune psychosis. Frontiers Media S.A. 2023-07-19 /pmc/articles/PMC10396436/ /pubmed/37539324 http://dx.doi.org/10.3389/fpsyt.2023.1206226 Text en Copyright © 2023 Liebrand, Rebsamen, Nakamura-Utsunomiya, von den Driesch, Köck, Caccia, Hamann, Wiest, Kaess, Walther, Tschumi, Hiyama and Kindler. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Psychiatry
Liebrand, Matthias
Rebsamen, Michael
Nakamura-Utsunomiya, Akari
von den Driesch, Luisa
Köck, Patrick
Caccia, Julien
Hamann, Christoph
Wiest, Roland
Kaess, Michael
Walther, Sebastian
Tschumi, Sibylle
Hiyama, Takeshi Y.
Kindler, Jochen
Case report: Psychosis and catatonia in an adolescent patient with adipsic hypernatremia and autoantibodies against the subfornical organ
title Case report: Psychosis and catatonia in an adolescent patient with adipsic hypernatremia and autoantibodies against the subfornical organ
title_full Case report: Psychosis and catatonia in an adolescent patient with adipsic hypernatremia and autoantibodies against the subfornical organ
title_fullStr Case report: Psychosis and catatonia in an adolescent patient with adipsic hypernatremia and autoantibodies against the subfornical organ
title_full_unstemmed Case report: Psychosis and catatonia in an adolescent patient with adipsic hypernatremia and autoantibodies against the subfornical organ
title_short Case report: Psychosis and catatonia in an adolescent patient with adipsic hypernatremia and autoantibodies against the subfornical organ
title_sort case report: psychosis and catatonia in an adolescent patient with adipsic hypernatremia and autoantibodies against the subfornical organ
topic Psychiatry
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10396436/
https://www.ncbi.nlm.nih.gov/pubmed/37539324
http://dx.doi.org/10.3389/fpsyt.2023.1206226
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