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Yıl:2009; Cilt: 16; Sayı: 3>> Özet
TAM METİN
Çocuk ve Gençlik Ruh Sağlığı Dergisi; 2009;16(3):148-152
Çocuk Psikiyatrisinde Rutin Biyokimya Tetkiklerinin Önemi: Wilson hastalığı
Ö Metin, F Toros
Mersin Üniv. Tıp Fak.
Wilson Hastalığı nadir görülen otozomal resesif kalıtılan bir bakır (Cu) metabolizması bozukluğudur. Wilson Hastalığının kliniği nadiren 5 yaşından önce kendini gösterir. Hastalar tipik olarak 10-40 yaşları arasında hepatik, nörolojik ya da psikiyatrik semptomlarla başvururlar. Çalışmamızda psikiyatrik semp- tomlarla Mersin Üniversitesi Çocuk Psikiyatrisi bölümüne başvuran 7 yaşındaki erkek olguda DSM-IV (Mental Bozuklukların Tanısal ve Sayımsal El Kitabı) tanı ölçütleri kullanılarak dikkat eksikliği hiperaktivite bozukluğu (DEHB) tanısı konulmuştur. Psikofarmakolojik tedavi öncesi yapılan temel biyokimya test sonuçlarında karaciğer fonksiyon testlerinde yükseklik saptanmış, çocuk hastalıkları bölümü tarafından yapılan karaciğer biyopsisi sonucunda Wilson hastalığı tanısı konulmuştur. Wilson nedeni ile uygulanan şelasyon tedavisi sonucunda olgumuzdaki DEHB belirtileri azalmış ve psikofarmakolojik tedaviye ihtiyaç kalmamıştır. Bu olgu; bizlere tedavi öncesinde yapılan temel biyokimyasal testlerin önemli olabileceğini göstermektedir.
Importance of routine biochemical study in child psychiatry case report: Wilson's disease
Wilson's Disease is a rare autosomal recessive inherited disorder of copper metobolism. Its sypmtoms rarely appear before the age of 5 [year]s. Patients present with liver, neurological, or psychiatric symptoms typically between the ages of 10 and 40. The reported case was a 7 [year]s old boy who applied to Child and Adolescent Psychiatry Department at Medical Faculty of Mersin University with psychiatric symptoms who had been diagnosed as attention deficiency hyperactivity disorder (ADHD) with using DSM- IV (Diagnostic and Statistical Manual of Mental Disorders) diagnostic criteria. Before psychopharmacological treatment the patient's biochemical laboratory results and other investigations were demanded. After the hepatic enzyme dsyfunctions were detected, the case was consulted by the pediatry department. The patient was diagnosed as Wilson's Disase after the hepatic biopsy. In this case, psychiatric symptoms were reduced after chelation therapy and the patient didn't need psychopharmacological therapy. This case shows us that using main biochemical tests may be necessary before the psychopharmacological therapy.

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