RESUMEN
BACKGROUND: Although resistance to thyroid hormone beta (RTHß) is associated with attention-deficit/hyperactivity disorder, there are few reports of other concomitant mood disorders in individuals with RTHß. CASE PRESENTATION: A 67-year-old woman who had been previously diagnosed with RTHß (Refetoff syndrome) came to our department as a depressed patient. She was hospitalized twice for depression and treated with antidepressants both times. Paroxetine (37.5 mg/day) treatment during the first hospitalization did not cause any side effects, but treatment with mirtazapine (15 mg/day) and venlafaxine (150 mg/day) during the second hospitalization caused clonus and disturbance of consciousness, and these adverse effects resulted in a prolonged period of hospitalization. Finally, the patient's symptoms were controlled with quetiapine (75 mg/day). CONCLUSION: Poor tolerability to antidepressants was observed, which may be related to thyroid hormone intolerance. Low doses of quetiapine may contribute to improvements in depression.
Asunto(s)
Síndrome de Resistencia a Hormonas Tiroideas , Anciano , Antidepresivos/efectos adversos , Femenino , Humanos , Mirtazapina/efectos adversos , Trastornos del Humor , Mutación , Paroxetina , Fumarato de Quetiapina/efectos adversos , Receptores beta de Hormona Tiroidea/genética , Síndrome de Resistencia a Hormonas Tiroideas/diagnóstico , Síndrome de Resistencia a Hormonas Tiroideas/tratamiento farmacológico , Síndrome de Resistencia a Hormonas Tiroideas/genética , Hormonas Tiroideas , Clorhidrato de Venlafaxina/efectos adversosRESUMEN
BACKGROUND: Leukoencephalopathy is identified during the administration of anticancer drugs. Symptoms vary from neurological symptoms to psychiatric symptoms depending on the site of damage. There have been no previous reports of suicide attempts due to drug-induced leukoencephalopathy. CASE PRESENTATION: The patient was diagnosed with diffuse large B-cell lymphoma (DLBCL) infiltrating the pharyngeal lesion. Rituximab + methotrexate + oncovin + procarbazine (R-MPV) therapy, a methotrexate-containing chemotherapy, was initiated. At the end of the fifth course, the patient attempted suicide by hanging with an appliance cord, which was associated with delusion. A head MRI scan showed no evidence of lymphoma recurrence, but white matter lesions around the ventricles showed progression. CONCLUSION: We report the case of a patient in whom drug-induced leukoencephalopathy related to methotrexate led to a suicide attempt. In addition to monitoring brain tumors, daily monitoring of psychiatric and neurological symptoms is important for patients with methotrexate-induced encephalopathy.
Asunto(s)
Leucoencefalopatías , Intento de Suicidio , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Humanos , Leucoencefalopatías/inducido químicamente , Leucoencefalopatías/diagnóstico por imagen , Imagen por Resonancia Magnética , Metotrexato/efectos adversosRESUMEN
Chronic ischemic enteritis can cause intestinal strictures, but extensive resection of the small intestine may leave patients with short bowel syndrome. Thus, the importance of preserving diseased small bowel is now recognized. We report a case of successful side-to-side isoperistaltic strictureplasty (SSIS), performed to prevent short bowel syndrome, in a patient with ischemic enteritis caused by strangulated intestinal obstruction. SSIS is useful for preserving the intestinal absorptive function in patients with a long narrowed bowel loop caused by ischemic change. To our knowledge, this is the first report of the successful treatment of a long stricture resulting from ischemic enteritis, achieved by performing SSIS.
