RESUMO
Rarely screened in psychiatric patients, primary and/or secondary Carnitine deficiency could be influencing and/or mimicking the mood symptoms of our patient population. The brain and specifically neurons are highly vulnerable to impairments in oxidative metabolism, which can lead to neuronal cell death and disorders of neurotransmitters causing changes in cognition and behavior. For this reason, identification of this disorder is important since its treatment could result in symptom improvement and better quality of life of our patients. We present a case where exacerbation of mood symptoms was associated to primary and secondary Carnitine deficiency.
Assuntos
Antimaníacos/efeitos adversos , Transtorno do Deficit de Atenção com Hiperatividade/complicações , Carnitina/deficiência , Hiperamonemia/psicologia , Complexo Cetoglutarato Desidrogenase/antagonistas & inibidores , Transtornos do Humor/complicações , Proteínas de Transporte de Cátions Orgânicos/deficiência , Ácido Valproico/efeitos adversos , Adulto , Antidepressivos/uso terapêutico , Transtorno do Deficit de Atenção com Hiperatividade/sangue , Benzodiazepinas/uso terapêutico , Carnitina/uso terapêutico , Citalopram/uso terapêutico , Transtorno Depressivo/complicações , Transtorno Depressivo/tratamento farmacológico , Transtornos Disruptivos, de Controle do Impulso e da Conduta/complicações , Substituição de Medicamentos , Quimioterapia Combinada , Humanos , Hiperamonemia/induzido quimicamente , Hiperamonemia/genética , Lorazepam/uso terapêutico , Masculino , Transtornos do Humor/sangue , Olanzapina , Proteínas de Transporte de Cátions Orgânicos/genética , Membro 5 da Família 22 de Carreadores de Soluto , Ácido Valproico/farmacologia , Ácido Valproico/uso terapêuticoRESUMO
Immunohistology of lymphoreticular tissues of a fatal case of organic cation transporter 2 deficiency revealed inhibited proliferation with increased apoptosis in the germinal centers, resulting in "burned out" follicles. This is indicative of impaired antigen driven B cell affinity maturation. Defective humoral immune response might explain the recurrent infections in untreated organic cation transporter 2 deficiency.