Marfan sendromunda Şizo-obsesyon
Marfan sendromu birçok organ belirtileriyle kendini gösteren bağ doku hastalığıdır. Daha önce Marfan sendromu- na eşlik eden ruhsal hastalıklar bildirilmiştir. Bu olguda Marfan sendromuna eşlik eden bir şizo-obsesif bozukluk olgusu sunulacak ve literatür gözden geçirilecektir. Otuz dokuz yaşında, uzun boylu ve uzun ekstremiteli, skolyo- zu olan kadın hasta psikiyatri polikliniğine sık el yıkama, aileye karşı öfke ve şüphe, evden kaçma şikayetleri ile yakınları eşliğinde başvurmuştur. Aile bireylerine karşı kötülük görme ve alınma sanrıları bulunan hasta hiçbir toplumsal etkinlikte bulunmuyordu. Aileden alınan anamnez ve fiziksel muayne sonucu marfan sendromu tanısı kardiyoloji, genetik, göz konsültasyonları ile doğrulandı. Eşlik eden çeşitli ruhsal hastalıklar literatürde bildirilse bile Marfan sendromu ile birlikte şizo-obsesif bozukluk eş tanısına şu ana kadar rastlanmamıştır. Olgu yüklü aile öyküsü ile daha önce bildirilmemiş bir klinik görünüm bakımından dikkat çekicidir.
Schizo-obsessive disorder in Marfan syndrome
Marfan syndrome is a connective tisuue disorder presenting with multiorgan symptoms. Cases of patients with mental disorders associated with Marfan syndrome were reported previously. We present a case with schizo- obsessive disorder comorbid with Marfan syndrome and literature about this condition will be discusssed. Thirthy nine years old, tall female with long limbs and scoliosis refered to psychiatric policlinic with her relatives with complaint of frequent hand washing, anger and doubt against her family and escapes from home. The patient who has delusion of persecution and reference did not have nearly any social activity. The diagnosis of Marfan syndrome was confirmed by history and physical examination with consultation to cardiology, medical genetics, and ophtalmology. Although mental diseases associated with Marfan syndrome was documented in literature, Marfan Syndrome with schizo-obsessive disorder was not coincided until now. Clinical presentation of a case with burdened family history which was not reported previously is noteworthy.
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- 1. Ramirez F, Carta L, Lee-Arteaga S. Fibrillin-rich microfibrils structural and instructive deter- minants of mammalian development and physio- logy. Connect Tissue Res 2008;49(1):1-6.
- 2. Dietz HC, Cutting GR, Pyeritz RE, Maslen CL, Sakai LY, Corson GM, et al. Marfan syndrome caused by a recurrent de novo missense muta- ion in the fibrillin gene. Nature 1991;352:279-81.
- 3. De Paepe A, Devereux RB, Dietz HC, Hennekam RC, Pyeritz R, et al. Revised diagnostic criteria for the Marfan syndrome. Am J Med Genet 1996;62(4):417-26.
- 4. Lemberg M, Thompson AW. Marfan syndrome and schizophrenia: a case report and literature review. Gen Hosp Psychiatry 2010;32(2):228-9.
- 5. Romano J, Linares RL. Marfan's syndrome and schizophrenia: a case report. Arch Gen Psychiatry 1987;44(2):190-2.
- 6. Leone JC, Swigar ME. Marfan's syndrome and neuropsychiatric symptoms: case report and literature review. Compr Psychiatry 1986;27(3):247-50.
- 7. Kalkman HO. Altered growth factor signaling pathways as the basis of aberrant stem cell maturation in schizophrenia. Pharmacol Ther 2009;121(1):115-22.
- 8. Purandare KN, Markar TN. Psychiatric symptom- matology of Lujan-Fryns syndrome: an X-linked syndrome displaying Marfanoid symptoms with autistic features, hyperactivity, shyness and schi- zophreniform symptoms. Psychiatric Genetics 2005;15:229-31.
- 9. Sirota P, Frydman M, Sirota L. Schizophrenia and Marfan Syndrome. Br J Psychiatry 1990;157:433-6.
- 10. Kalsi G, Mankoo BS, Brynjolfsson J, Curtis D, Read T, Murphy P, et al. The Marfan syndrome gene locus as a favoured locus for susceptibility to schizophrenia. Psychiatr Genet 1994;4(4):219-27.