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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...
Autores principales: | , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Frontiers Media S.A.
2023
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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. |
format | Online Article Text |
id | pubmed-10396436 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
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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