Mood disorder with mixed, psychotic features due to vitamin b12 deficiency in an adolescent: case report

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dc.authorid0000-0001-5207-6240
dc.authorid0000-0001-6040-6174
dc.authorid0000-0001-5259-1154
dc.contributor.authorTufan, Ali Evren
dc.contributor.authorBilici, Rabia
dc.contributor.authorUsta, Genco
dc.contributor.authorErdoğan, Ayten
dc.date.accessioned2021-06-23T18:56:18Z
dc.date.available2021-06-23T18:56:18Z
dc.date.issued2012
dc.departmentBAİBÜ, Tıp Fakültesi, Dahili Tıp Bilimleri Bölümüen_US
dc.description.abstractVitamin B12 is one of the essential vitamins affecting various systems of the body. Reports of psychiatric disorders due to its deficiency mostly focus on middle aged and elderly patients. Here we report a case of vitamin B 12 deficiency in a 16-year old, male adolescent who presented with mixed mood disorder symptoms with psychotic features. Chief complaints were " irritability, regressive behavior, apathy, crying and truancy" which lasted for a year. Premorbid personality was unremarkable with no substance use/exposure or infections. No stressors were present. The patient was not vegetarian. Past medical history and family history was normal. Neurological examination revealed glossitis, ataxia, rigidity in both shoulders, cog-wheel rigidity in the left elbow, bilateral problems of coordination in cerebellar examination, reduced swinging of the arms and masked face. Romberg's sign was present. Laboratory evaluations were normal. Endoscopy and biopsy revealed atrophy of the gastric mucosa with Helicobacter Pylori colonization. Schilling test was suggestive of malabsorbtion. He was diagnosed with Mood disorder with Mixed, Psychotic Features due to Vitamin B12 Deficiency and risperidone 0.5 mg/day and intramuscular vitamin B12 500 mcg/day were started along with referral for treatment of Helicobacter pylori. A visit on the second week revealed no psychotic features. Romberg's sign was negative and cerebellar tests were normal. Extrapyramidal symptoms were reduced while Vitamin B12 levels were elevated. Risperidone was stopped and parenteral Vitamin B12 treatment was continued with monthly injections for 3 months. Follow-up endoscopy and biopsy at the first month demonstrated eradication of H. pylori. He was followed monthly for another 6 months and psychiatric symptoms did not recur at the time of last evaluation. Despite limitations, this case may underline the observation that mood disorders with psychotic features especially with accompanying extrapyramidal symptoms lacking a clear etiology may be rare manifestation of vitamin B12 and/or folate deficiency in children and adolescents and be potentially amenable to treatment.en_US
dc.description.urihttps://capmh.biomedcentral.com/track/pdf/10.1186/1753-2000-6-25.pdf
dc.identifier.doi10.1186/1753-2000-6-25
dc.identifier.issn1753-2000
dc.identifier.issue1
dc.identifier.scopus2-s2.0-84862512401en_US
dc.identifier.scopusqualityQ1en_US
dc.identifier.urihttps://doi.org/10.1186/1753-2000-6-25
dc.identifier.urihttps://hdl.handle.net/20.500.12491/4977
dc.identifier.volume6en_US
dc.indekslendigikaynakScopusen_US
dc.institutionauthorTufan, Ali Evren
dc.language.isoenen_US
dc.relation.ispartofChild and Adolescent Psychiatry and Mental Healthen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/openAccessen_US
dc.subjectExtrapyramidal Symptomsen_US
dc.subjectMood Disorderen_US
dc.subjectPsychosisen_US
dc.subjectVitamin B12en_US
dc.titleMood disorder with mixed, psychotic features due to vitamin b12 deficiency in an adolescent: case reporten_US
dc.typeArticleen_US

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