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Yıl:2019; Cilt: 32; Sayı: 3>> Özet
TAM METİN
Düşünen Adam: Psikiyatri ve Nörolojik Bilimler Dergisi; 2019;32(3):268-270
Bir Olgu Bağlamında Beckwith Wiedemann Sendromu ve Otizm Spektrum Bozukluğu Birlikteliği
A Alnak, DB Ozdemirci, M Coskun
Otizm spektrum bozukluğu (OSB), belirtileri erken yaşamda başlayan, iletişimde ve sosyal becerilerde yetersizlikler ve tekrarlayıcı davranışlar ve/veya sınırlı ilgi alanları ile karakterize olan nörogelişimsel bir bozukluktur. Beckwith-Wiedemann sendromu (BWS) klinik olarak makroglossi, viseromegali, hemihipertrofi, karın duvar defektleri ve diğer başka gelişimsel anormalliklerle karakterize bir aşırı büyüme sendromudur. Literatürde BWS tanılı çocuk ve ergenlerde, OSB de dahil olmak üzere artmış nörodavranışsal anormallikler olduğu bildirilmiştir. Bu yazıda, OSB ve BWS tanıları olan ve babasının ani kaybı sonrasında davranışsal değişikliklerle başvuran bir 7 yaşında erkek bir olgu sunulmuştur. İlk psikiyatrik değerlendirme ve incelemeler sonucunda OSB tanısı konfirme edildi ve semptom alevlenmelerinin yaşadığı kayıp ile ilgili olduğu düşünüldü. Aileye yönelik psikoeğitim verildi ve essitalopram 0,5mg/gün başlanarak kademeli olarak 2,5 mg/gün’e çıkılması planlandı.Bu müdahaleden bir ay sonraki kontrol görüşmesinde aile semptomlarda belirgin iyileşmeler olduğunu belirtti. BWS’nin nörogelişimsel bozukluklarla ilişkisi diğer genetik sendromlar kadar iyi bilinmemektedir. Bu nedenle bir olgu bağlamında OSB’nin BWS dahil olmak üzere diğer “imprinting” bozukluklarla ilişkisinin araştırılmasının önemine dikkat çekmeyi amaçladık.
Co-existence of Beckwith-Wiedemann syndrome and autism spectrum disorder
Autism spectrum disorder (ASD) is an early-onset neurodevelopmental disorder characterized by deficits in communicative and social skills and repetitive behaviors and/or restricted interests. The genetic mechanism underlying ASD is as complex and heterogeneous as its clinical heterogeneity. Beckwith-Wiedemann syndrome (BWS) is a well-known human imprinting disorder characterized by macroglossia, visceromegaly, hemihypertrophy, abdominal wall defects and a number of other various developmental abnormalities with an increased risk for embryonal tumors. In the literature, a greater frequency of neurobehavioral issues including ASD has been reported in children with BWS. Here, we present a 7-year-old boy diagnosed with ASD and BWS admitted to our clinic with complaints of emotional and behavioral changes after suddenly losing his father due to myocardial infarction. Upon initial assessment and psychiatric examination, the ASD diagnosis was confirmed and the exacerbation of the symptoms was assumed to be related with his bereavement. The family was given psychoeducation and the boy was started on escitalopram 0.5 mg/day, gradually increased to 2.5 mg/day. One month after this intervention, the family reported significant improvements in his symptoms. Although BWS has not been studied as extensively as other genetic conditions associated with neurodevelopmental disorders, it may be important for us to expand our knowledge about ASD accompanying human imprinting diseases including BWS.

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