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Yıl:2016; Cilt: 53; Sayı: 3>> Özet
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Nöropsikiyatri Arşivi; 2016;53(3):280-282
Kabuki Sendromu Olan Bir Çocukta Otizm Spektrum Bozukluğu
M Sertçelik, Ç Uğur, AŞ Aközel, CK Gürkan
Ankara Üniversitesi, Ankara
Kabuki sendromu (KS) iskelet anomalileri, boy kısalığı, bazı karakteristik yüz bulguları, doğum sonrası gelişme geriliği ve mental retardasyon ile belirli bir sendromdur. Yazında KS ile Otizm Spektrum Bozukluğu (OSB) birlikteliği görülen çok az sayıda olgu bildirilmiştir. Burada KS olan ve OSB tanısı konan bir erkek çocuk bildirilmiş ve etyolojik açıdan muhtemel ortak noktalar tartışılmıştır. Bir erkek çocuğu 4 yaşındayken kliniğimize konuşamama, aşırı hareketlilik, enürezis kompleks, öfke nöbetleri, kendine, başkalarına ve eşyalara zarar verme şikayetleriyle ailesi tarafından getirildi. Yapılan psikiyatrik değerlendirmelerde konuşmada gerilik, göz temasında kısıtlılık, stereotipik hareketler, sosyal iletişim ve etkileşimde kısıtlılık saptandı, “Otizm” ve “Ağır Derecede Mental Retardasyon” tanısı konuldu. Olgunun 2 aylıktan itibaren pediatri bölümünde takip edildiği öğrenildi. Dış merkezde yapılan fizik incelemede hastanın uzun kirpikli, antevert kulaklı, geniş palpebral aralıklı, göz kapaklarının lateral 1/3’ünün everte, burun kökünün basık, boyunun kısa olduğu görülmüş. Brakidaktilisi, fetal finger padleri, opere ventral septal defekti (VSD) ve nöbetleri olan hastaya 5 yaşındayken KS tanısı konuldu. Hastamıza özel eğitim raporu düzenlendi, okul öncesi eğitime başlatılması önerildi ve takibe alındı. Olgumuz yazında çok az sayıda bildirilen KS ve OSB birlikteliğini ortaya koyan yeni bir örnektir. KS gibi spesifik sendromların varlığında yapılacak genetik analizler, OSB’lerin genetik etyolojisinin anlaşılması ve tedavi yaklaşımları açısından yeni açılımlar sağlayabilir.
A Child with Kabuki Syndrome and Autism Spectrum Disorder
Kabuki syndrome (KS) is characterized by skeletal abnormalities, short stature, characteristic facial features, postnatal growth delay, and mental retardation. There are only a few case reports that present the coexistence of KS with autism spectrum disorder (ASD) in the literature Herein we present the case of a boy with KS and ASD and discuss the possible shared etiologies. A 4-year-old boy was brought by his parents with complaints of no speech, hyperactivity, enuresis complex, temper tantrum, self-injury, and harming people or objects. We determined the lack of speech and eye contact, stereotypical behavior, and impaired social interaction and diagnosed him with autism and severe mental retardation via a psychiatric assessment. He had been followed up by pediatricians until he was 2 years old. Pediatricians noted his long eyelids with eversion of the lateral third of the lower eyelid, depressed nasal tip, short stature, long palpebral fissures, brachydactyly, and fetal finger pads in their physical examination. The boy who has an operated ventral septal defect and seizures was diagnosed with KS when he was 5 years old. We recommended his parents to apply to a special education agency and kindergarten for him. Our case is a new example of the coexistence of KS and ASD in addition to the very few cases in the literature. Genetic analyses conducted in the existence of specific genetic syndromes, such as KS, may provide opportunities for understanding the genetic etiology of ASD and new scope in terms of novel treatment approaches.

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