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題 名 | Psychiatric Manifestations of Acute Intermittent Porphyria: A Case Report=急性間歇性紫質症的精神表徵:一例報告 |
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作 者 | 邱念睦; 洪禎雯; 李昱; 林祖功; | 書刊名 | 臺灣精神醫學 |
卷 期 | 13:1 1999.03[民88.03] |
頁 次 | 頁74-80 |
分類號 | 415.9 |
關鍵詞 | 急性間歇性紫質症; 未分化型身體疾患; 其他未註明之精神病性疾患; 物質濫用; Acute intermittent porphyria; Undifferentiated somatoform disorder; Psychotic disorder not otherwise specified; Substance abuse; |
語 文 | 英文(English) |
中文摘要 | 目的:探討一例罕見急性間歇性紫質症合併多發性神經炎及精神表徵之鑑別診斷問 題。 病例報告:一位二十八歲女性曾因被懷囊炎而於某醫院接受膽囊除手術。術後三個月仍有腹 痛加劇、嘔吐、厭食、低血鈉而於本院胃腸科住院,出院診斷為不明原因腹痛及低血鈉症。 。出院十個月後,因仍有非特異疼痛、焦慮、激動、止痛劑及苯二酚濫用而二度住進精神科 急性病房治療,診斷分別為未分化型身體疾患、不典型精神病及物質濫用。在治療穩定五個 月後,個案突然出全身虛弱、癱瘓、肌肉疼痛、呼吸衰竭,經急診氣管切開及呼吸器輔助呼 吸後, 於神經科及復健科住院近五個月, 經二十四小時尿液檢測 porphobilinogen 及 δ -aminolevulinic acid 值偏高後,確定診斷。 結論:因急性陣發性紫質症是一種容易與精神科其他診斷混淆的疾病,精神科醫師需要瞭解 此症的特性,以避免延誤或不正確診斷。 |
英文摘要 | Objective: We discuss the problems of differential diagnosis in case of acute intermittent porphyria (AIP) coexisting with polyneurolpathy and psychiatric manifestation. Case Report: This 28 year-old female had received cholecystectomy for suspected gall bladder stone with cholecystitis at another hospital. Three months later. She was admitted to our gastroenterology ward because of exaggerbated abdominal pain, vomiting and anorexia and was discharged under a dual diagnosis of undetermined abdominal pain and hyponatremia. She was admitted to our psychiatric ward twice because of nonspecific pain, anxiety, agitation, and abuse of anagelsics and benzodiazepines about ten months later. She was treated under different diagnoses including undifferentiated somatoform disorder, psychotic disorder not otherwise specified and substance abuse. About five months later, she suddenly developed general weakness, paralysis, muscle pain and respiratory failure and was admitted to emergency room where tracheotomy and artificial ventilation supportwere performed. The AIP diagnosis was confirmed by subsequent elevation of 24 hour urine porphobilinogen (PBG) and 5@aminolevulinic acid (ALA) during nearly five months hospitalization at the neurology and rehabilitation ward. Conclusion: Because AIP is easily confused with other psychiatric disorders, it is important for the psychiatrist to be aware of its beguiling nature in order to avoid delayed or incorrect diagnosis. |
本系統中英文摘要資訊取自各篇刊載內容。