A Case of Klinefelter's Syndrome with Schizophrenia-Like Symptoms.

Hirasawa, Hideto; Asakawa, Osamu; Koyama, Keiko; Takahashi, Yoshitomo; Atsumi, Yoshitaka; Kumakura, Tetsuo

doi:10.3143/geriatrics.37.495

Cited by 4 publications

(3 citation statements)

References 2 publications

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“…Além da ginecomastia bilateral, outras formas menos comuns de manifestação primária da doença podem surgir, como hemorragia cerebelar, tumor de células de Leydig, esquizofrenia, teratoma retroperitoneal e cardiopatias congênitas (12)(13)(14)(15)(16).…”

Section: Discussionunclassified

Diagnóstico tardio da síndrome de Klinefelter: relato de caso

Maia¹,

Coelho²,

Andrade³

et al. 2002

Arq Bras Endocrinol Metab

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RESUMOKlinefelter's syndrome (KS) results from a genetic deficiency (kariotype 47,XXY) that can lead to hypergonadotropic hypogonadism, azoospermia and underdevelopment of secondary sex characteristics. The exact mechanism that determines the androgenic deficiency is not yet understood, and the degree of Leydig cell dysfunction is variable. KS is a chronic disease with serious repercussions over the male reproductive system and also an important cause of infertility worldwide. We report on a 33 year-old male patient with progressive bilateral and painful gynecomastia, hypergonadotropic hypogonadism and associated emotional disturbances. The presence of signs and symptoms of androgen deficiency along with the demonstration of a 47,XXY kariotype led to the diagnosis of KS involving the patient in an uncommon syndrome of infertility and feminization and its biopsychosocial implications. A SÍNDROME DE KLINEFELTER (SK) é um estado intersexual, determinado geneticamente pela duplicação do cromossomo X, caracterizada por alterações tardias que se tornarão evidentes após a puberdade (1). É uma forma de manifestação de ginecomastia, estimando-se sua incidência em 1 caso para cada 850 homens (2). Consiste em uma das causas mais importantes de infertilidade masculina e hipogonadismo primário em nosso meio (3,4). Cerca de 10% dos azoospérmicos são portadores de SK (5).

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Section: Discussionunclassified

Diagnóstico tardio da síndrome de Klinefelter: relato de caso

Maia¹,

Coelho²,

Andrade³

et al. 2002

Arq Bras Endocrinol Metab

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“…Se le nium is re quired for ap pro pri ate thyroid hor mone syn the sis, ac ti va tion, and me tabo lism (3,4). Among all or gans, the hu man thy roid gland has the high est sele nium con tent per gram of tis sue.…”

Section: Case Reportmentioning

confidence: 99%

The World Trade Center Disaster

Fernando¹

2002

Can J Psychiatry

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This in turn may regu late the do pa min ergic func tion. This lat ter study found that cas tra tion de creased the 5-HT2 A -r eceptor bind ing sites, the con tent of 5-HT2 A mes sen ger ri bo nu cleic acid (mRNA), and the serotonin-transporter bind ing sites in the brain, thus de creas ing the sero to ner gic trans mis sion. Con versely, admini stra tion of tes tos ter one had the op po site ef fect. When viewed in light of the well-chronicled in hibi tory role of the se ro to ner gic sys tem over the do pa min ergic sys tem, es pe cially in the fron tal areas, this in di cates that fal ling tes tos ter one lev els con se quent to cas tration cause a hy per do pa min er gic state. These ob ser va tions thus in di rectly support the hy pothe sis that tes tos ter one protects against schizo phre nia by modu lat ing the neu ro trans mit ters im plicated in the dis or der. A simi lar role for es tra diol is more ac cepted in the lit erature; whether tes tos ter one ex erts its protec tive ac tion via con ver sion to es tra diol (7) is a ques tion that opens new ave nues for elu ci dat ing its im pact on the psy chopa thol ogy of schizo phre nia. The psy cho logi cal im pact of the World Trade Cen ter dis as ter was more sig nificant than simi lar pre vi ous in ci dents, partly be cause of the live tele vi sion cover age. I re port 3 cases of pa tients af fected by this trauma. Ref er ences Case Report 1On Sep tem ber 20, 2001, a 36-year-old man who is an as sem bly worker at a lo cal fac tory was ad mit ted through the emergency de part ment of our gen eral hos pital. He was in a psy chotic state, suf fer ing from con fu sion and para noia. Ap parently, around Sep tem ber 11, a fel low worker of East In dian ori gin left the factory abruptly, and from that point on the pa tient was con stantly wor ry ing, as suming the worker to be in some way connected to the dis as ter. Al though that par ticu lar worker re turned to work af ter a few days, the pa tient con tin ued to worry. He did not sleep ade quately and ul ti mately be came con fused and needed hos pi tali za tion.The pa tient had a his tory of 2 psy chotic epi sodes, both pre cipi tated by stress, that re solved com pletely within a week of treat ment. There was no his tory of al cohol or drug abuse or any sig nifi cant family his tory of men tal ill ness. He has a sta ble mar riage and has been func tion ing quite well at his work place for the last 15 years. He sta bi lized within 24 hours of ad mis sion and was dis charged af ter 3 days, with a pre scrip tion of queti apine 100 mg, to be taken at bed time. Case Report 2A 52-year-old fe male out pa tient suf fering from dysthymic dis or der and chronic anxi ety, with a his tory of sex ual abuse, was men tally sta ble prior to the dis as ter. Sub se quently, she be came in creas ingly de pressed, anx ious, and agi tated. She suf fered from in som nia and com plained of night mares in which her abu sive exhusband was the pi lot of one of the planes in volved in the dis as ter. This patient sta bi lized quick...

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confidence: 99%

Acute Onset of Schizophrenia following Autocastration

Duggal¹,

Jagadheesan²,

Nizamie³

2002

Can J Psychiatry

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ex clud ing in di vidu als ex press ing no opin ion rep re sent equally invalid methods of in flat ing the ap par ent ac cep tance of dis so cia tive dis or ders and do not make a large nu meri cal dif fer ence, in any case.Sim ply stated, one may choose to in terpret our find ings as show ing that the glass is ei ther half-full or half-empty (as we have noted be fore [3]), but by any standard one can not claim that there is any con sen sus one way or the other on the diag nos tic status or sci en tific va lid ity of the dis so cia tive dis or ders. Auto cas tra tion is a rare form of geni tal self-mutilation tra di tion ally as so ci ated with pa tients suf fer ing from acute psycho sis, es pe cially those har bour ing re ligious de lu sions and hav ing other risk fac tors (1). We pres ent a case of auto castra tion oc cur ring dur ing the pro drome of schizo phre nia, with florid psy cho sis emerg ing only af ter the act. We dis cuss pos si ble neu ro en do cri nal and neu ro transmit ter in ter ac tions un der ly ing the ap pearance of this schizophrenia-like psy cho sis af ter cas tra tion. Ref er ences Case ReportThe pa tient, a 26-year-old mar ried man, was ad mit ted with a re cent psy chotic exac er ba tion of a 5-year ill ness char ac ter ized by sus pi cious ness, hear ing sounds, un pro voked ir ri ta bil ity, un predict able vio lence, in ap pro pri ate mood states, awk ward pos tures, and pro gressive per son al ity de te rio ra tion. He was diag nosed with un dif fer en ti ated schizo phre nia ac cord ing to the ICD-10 cri te ria. Al though he had a his tory of sexual abuse and pe do philic be hav iour dating from early ado les cence, he did not dis play any traits sug gest ing a per son al ity dis or der. The first changes in his de meanour were no ticed when, fol low ing the loss of his job in 1995, he be came sad and aloof. He also ex pe ri enced sleep dis turbance that gradu ally wors ened over the next 6 months. To ward the end of this 6-month pe riod, he be came more re lig ious as well. Dur ing this time, how ever, there was no de pres sive cog ni tion or overt psycho sis. As his sleep de te rio rated, he consulted many gen eral prac ti tio ners, but with out much re lief. One day, dis tressed be cause of this lack of sleep, the pa tient im pul sively de cided to com mit sui cide. He went to a lonely hill, where he first thought of stab bing him self but then instead cas trated him self, be liev ing this to be more le thal. Us ing a knife, he completely ex cised the scro tum at its base and then threw the tes tes away, but left his penis un touched. He felt no pain dur ing the act. For tu nately, he was res cued and the re main ing part of the scro tum was sutured. Fol low ing re cu pera tion in a hos pital, he was dis charged af ter 15 days. The tes tes were not re at tached, nor was he started on tes tos ter one. As as sessed by a psy chia trist, the pa tient had no psy chotic symp toms dur ing the hos pi tal stay, and his only rea son for com mit ting the act was a genu ine wish to die, p...

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A Case of Klinefelter's Syndrome with Schizophrenia-Like Symptoms.

Cited by 4 publications

References 2 publications

Diagnóstico tardio da síndrome de Klinefelter: relato de caso

Diagnóstico tardio da síndrome de Klinefelter: relato de caso

The World Trade Center Disaster

Acute Onset of Schizophrenia following Autocastration

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