Psychological signs as the only presentation of Wilson’s disease in an 11 year-old boy (a case report)

Mehran Beiraghi toosi--- Department of Pediatric neurology. Ghaem hospital. Mashhad University of Medical Sciences, Mashhad,Iran,
Javad Akhondian--- Department of Pediatric neurology. Ghaem hospital. Mashhad University of Medical Sciences, Mashhad,Iran,
Farah Ashrafzadeh--- Department of Pediatric neurology. Ghaem hospital. Mashhad University of Medical Sciences, Mashhad,Iran,
Nahid Donyadideh--- Department of Pediatric neurology. Ghaem hospital. Mashhad University of Medical Sciences, Mashhad,Iran,
Asma Javid--- Department of Pediatrics, Mashhad University of Medical Sciences, Mashhad, Iran

Abstract


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Wilson’s disease (WD) is a rare autosomal recessive disease due to copper metabolism disturbance. The clinical presentation spectrum of Wilson’s disease is wide and initial findings of the disease depend on the organ involved. Neurologic disorders can develop insidiously or precipitously with intention tremor, dysarthria, rigid dystonia, parkinsonism, deterioration in school performance or behavioral changes. The aim of this article is presenting an 11-year old boy with chief complaint of falling and upper limb spasm referred to our center. His symptoms began from 6 month earlier as mood instability (prolonged spontaneous crying). He was also suffering from occasionally tremor and micrographia. Initial work ups were normal and with diagnosis of depression and psychiatric problems he was undergone treatment of fluoxetine and risperidone. Finally, concluded that Wilson’s disease should be considered in the diagnosis of all children with psychiatric and musculoskeletal symptoms.


Keywords


Wilson disease, psychological symptoms, child

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References


Kliegman RM, Stanton B, Geme JS, Schor NF, Behrman RE. Nelson textbook of pediatrics: Elsevier Health Sciences; 2015.

Ala A. Wilson's disease. Medicine. 2015;43(11):661-3.

El-Karaksy H, Fahmy M, El-Raziky MS, El-Hawary M, El-Sayed R, El-Koofy N, et al. A clinical study of Wilson’s disease: The experience of a single Egyptian Paediatric Hepatology Unit. Arab Journal of Gastroenterology. 2011;12(3):125-30.

Ala A, Walker AP, Ashkan K, Dooley JS, Schilsky ML. Wilson's disease. The Lancet. 2007;369(9559):397-408.

Roberts EA, Schilsky ML. Diagnosis and treatment of Wilson disease: an update. Hepatology. 2008;47(6):2089-111.

Nicastro E, Ranucci G, Vajro P, Vegnente A, Iorio R. Re‐evaluation of the diagnostic criteria for Wilson disease in children with mild liver disease. Hepatology. 2010;52(6):1948-56.

Akil M, Brewer GJ. Psychiatric and behavioral abnormalities in Wilson's disease. Advances in neurology. 1994;65:171-8.

Dening T, Berrios G. Wilson's disease: a longitudinal study of psychiatric symptoms. Biological psychiatry. 1990;28(3):255-65.

Lorincz MT. Neurologic Wilson's disease. Annals of the New York Academy of Sciences. 2010;1184(1):173-87.

Lang C, Müller D, Claus D, Druschky K. Neuropsychological findings in treated Wilson's disease*. Acta neurologica scandinavica. 1990;81(1):75-81.

Lang C. Is Wilson's disease a dementing condition? 1989.

Taly AB, Meenakshi-Sundaram S, Sinha S, Swamy H, Arunodaya G. Wilson disease: description of 282 patients evaluated over 3 decades. Medicine. 2007;86(2):112-21.

Aggarwal A, Aggarwal N, Nagral A, Jankharia G, Bhatt M. A novel global assessment scale for Wilson's disease (GAS for WD). Movement Disorders. 2009;24(4):509-18.

Bayram AK, Gümüş H, Arslan D, Özçora GK, Kumandaş S, Karacabey N, et al. Neurological features and management of Wilson disease in children: an evaluation of 12 cases. 2016.

Association AP. Diagnostic and statistical manual of mental disorders (DSM-5®): American Psychiatric Pub; 2013.




DOI: http://dx.doi.org/10.22037/ijcn.v12i2.14316

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