Birim Gunay Kilic, Pinar Uran Kurtgoz, Yuksel Sumeyra Karagoz

Aripiprazol Nieman Pick Psikozunda En Uygun Tedavi Seçeneği midir?

Niemann Pick Tip C (NPC) nadir görülen otozomal resesif lizozomal depo hastalığıdır. Progresif nörolojik bozulma ve erken ölüm ile karakterize oldukça heterojen bir görünüme sahiptir. Hastalık kendisini tek başına veya çeşitli kombinasyonlarda visseral, nörolojik, psikiyatrik bozukluklar olarak gösterir. Klinik tablo başlangıç yaşına göre değişir. Çocuk Metabolizması Bölümü’nden NP-C tanısı ile takipli 17 yaşında kız hasta referansiyel ve perseküsyon sanrıları nedeniyle danışıldı. Yapılan psikiyatrik muayene ve psikometrik değerlendirmelerden sonra hastaya akut psikotik atak ve mental retardasyon tanısı konuldu. Değerlendirmelerden sonra risperidon tedavisine başlandı. Risperidon tedavisinden sonra epileptik nöbetler meydana geldi. Nöbetleri kontrol ettikten sonra risperidon tedavisini aripiprazole çevirildi. Psikotik belirtileri azalan hastanın aripiprazol tedavisi ve psikososyal müdahalesi devam etmektedir. NP-C hastalığı nadir görülen bir hastalıktır ve psikiyatrik semptomlara neden olabilir. Juvenil başlangıçlı psikotik durumlarda gelişim öyküsü ve ilişkili nörolojik semptomların sorgulanması, altta yatan NP-C hastalığını düşündürebilir. NP-C’de görülen psikiyatrik semptomların tedavisi ile ilgili çok fazla araştırma bulunmamaktadır. Bu olgu sunumunda NP-C hastalığının psikiyatrik semptomlarla tedavisi ve psikiyatrik semptomların tedavisi vurgulanmıştır. Aripipirazol, NP-C’de görülen psikotik semptomların tedavisi için bir seçenek olabilir.

Is Aripiprazole the Most Appropriate Option in the Treatment of Niemann Pick Type C Disease Psychosis?

Niemann Pick Type C (NPC) is a rare autosomal recessive lysozomal depot disease. It has highly heterogeneousappearance characterized by progressive neurological deterioration and premature death. The disease manifests itself as visceral,neurological, psychiatric disorders alone or in various combinations. The clinical presentation varies according to the age of onset.A 17-year-old girl was referred with the diagnosis of NP-C, consulted by Pediatric Metabolism Department due to the referentialand persuasion delusions. After Psychiatric examination and psychometric evaluations the patient was given the diagnosis of acutepsychotic episode and mental retardation. We started the risperidone treatment after evaluations. After risperidone treatmentepileptic seizures have occurred. After controlling the seizures, we switched the risperidone treatment to aripiprazole. Aripiprazoletreatment and psychosocial intervention of the patient whose psychotic symptoms have diminished continues. NP-C disease is a raredisease and may cause psychiatric symptoms. The questioning of developmental history and associated neurological symptoms injuvenile-onset psychotic conditions may suggest underlying NP-C disease. There is no much research with respect to treatment ofpsychiatric symptoms seen in NP-C. In this case report, the treatment of NP-C disease with psychiatric symptoms and treatment ofpsychiatric symptoms were emphasized. Aripipirazole might be an option for treatment of psychotic symptoms seen in NP-C

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