[Encephalitis associated to anti-NMDA receptor antibodies: a description of two cases in the child/youth population]. / Encefalitis asociada a anticuerpos antirreceptor de NMDA: descripcion de dos casos en poblacion infantojuvenil.

INTRODUCTION: The clinical diagnosis of encephalitis due to anti-glutamate receptor N-methyl D-aspartate (NMDA) antibodies (anti-NMDA encephalitis) is made more complex by the fact that psychiatric clinical features are usually predominant in the early stages. This can lead to a delay in the diagnosis, treatment and prognosis of the disease. CASE REPORTS: We report on two clinical cases attended by the Child/Youth Psychiatry Section of our hospital, in collaboration with the Paediatric and Neurology services. Case 1: a 4-year-old male who was referred owing to behavioural alterations and the regression of previously acquired skills. Case 2: a 13-year-old female who was admitted due to a behavioural disorder within the context of a possible initial psychotic episode. In both cases appropriate complementary tests were performed, including lumbar puncture and anti-NMDA antibodies, which were positive. Once the diagnosis of anti-NMDA encephalitis had been reached, treatment was started: in the first case, with intravenous perfusion of corticoids and immunoglobulins, while in the second rituximab had to be associated. Both patients progressed towards clinical improvement. CONCLUSIONS: Over the last two years there has been an increase in the number of cases of anti-NMDA encephalitis diagnosed in the child/youth population. It is a neuropsychiatric, autoimmune condition, which can correspond to a paraneoplastic syndrome. Follow-up and transvaginal ultrasonography as well as thoracoabdominal computerised axial tomography scans are recommended for at least two years after diagnosis. Early diagnosis and treatment are important, which means that a multi- and interdisciplinary approach is required.

Trastorno obsesivo-compulsivo / Obsessive-compulsive disorder

Se presenta el caso de un niño con conducta acumuladora, episodios de agitación psicomotriz y ansiedad, así como ideas autolíticas cuando se pone freno a estas conductas. Durante su estancia en el hospital, se observa una tendencia a recoger desperdicios y basura, incluso sus propias heces. Las pruebas complementarias no detectan ningún signo orgánico ni infeccioso. Con el diagnóstico de trastorno obsesivo-compulsivo, se instaura tratamiento con sertralina y risperidona (AU)

We report the case of a child with hoarding behavior, agitation and anxiety, as well as self-injurious urges when these behaviors were stopped. While he was in the hospital, he was observed to have a tendency to pick up wastes and rubbish, even his own feces. Supplementary tests revealed no organic or infectious alterations. With the diagnosis of obsessive-compulsive disorder, treatment with sertraline and risperidone was initiated (AU)

[Asperger syndrome associated with macrosomia and sexual identity disorder]. / Síndrome de Asperger asociado a macrosomía y trastorno de identidad sexual.

Asperger Syndrome is a pervasive developmental disorder of unknown origin, characterized by pedantic language, lack of reciprocity in social interactions, unusual interests, motor clumsiness and normal or above average intelligence quotient, among other symptoms. Since 1994 it has been defined as a specific entity. We describe the case of a boy with this syndrome, with elevated body weight and height and sexual identity disorder. These alterations have not previously been described in the scientific literature on Asperger syndrome.

Síndrome de Asperger asociado a macrosomía y trastorno de identidad sexual / Asperger syndrome associated with acrosomia and sexual identity disorder

El síndrome de Asperger es un trastorno generalizado del desarrollo de causa desconocida, caracterizado por la presencia de un léxico pedante, falta de empatía en las relaciones sociales, intereses inusuales, torpeza motora y coeficiente de inteligencia normal o elevado, entre otros síntomas. Desde 1994 está definido como entidad específica. Se describe el caso de un niño afectado por este síndrome, con peso y talla elevados y trastorno de la identidad sexual, alteraciones no descritas en el síndrome de Asperger, hasta este momento, en la literatura científica

Asperger Syndrome is a pervasive developmental disorder of unknown origin, characterized by pedantic language, lack of reciprocity in social interactions, unusual interests, motor clumsiness and normal or above average intelligence quotient, among other symptoms. Since 1994 it has been defined as a specific entity. We describe the case of a boy with this syndrome, with elevated body weight and height and sexual identity disorder. These alterations have not previously been described in the scientific literature on Asperger syndrome