Neurodegeneration with brain iron accumulation associated with late-onset psychiatric symptoms
Autor(a) principal: | |
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Data de Publicação: | 2022 |
Outros Autores: | , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Debates em Psiquiatria (Online) |
Texto Completo: | https://revistardp.org.br/revista/article/view/386 |
Resumo: | Introduction: The neurodegeneration with brain iron accumulation (NBIA) is a heterogeneous group of rare genetic disorders that lead to accumulation of iron in the basal nuclei, which leads to numerous neurologic disorders. This condition has been associated with many genes, PKAN2 being the most common. The treatment remains mostly symptomatic and the approach based on a multidisciplinary team is recommended. Case report: The case presented is from a 67-year-old male with iron accumulation bilaterally in the pale globes and has been having delirium for 8 months, as well as visuospatial and executive dysfunction and behavioral alterations. The patient's MRI showed abnormalities and the “eye of the tiger” sign. Furthemore, the treatment of choice was the administration of atypical antipsychotic medication, which partially controlled the patient's condition. Discussion: The most recurrent location of brain iron accumulation is in the basal ganglia and it is mainly linked with mutations in the pantothenate kinase 2 (PKAN2), which leads to psychiatric manifestations of insidious progression and can be inferred when the “eye of the tiger” sign is found in a MRI. Conclusion: The patient was diagnosed with late onset psychotic disorder, mild cognitive deficit and parkisonian syndrome. Genetic tests were not performed to diagnose the etiology. Therefore, the case is considered a NBIA of unknown cause with atypical characteristics and probable mutation linked to PANK2. |
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Neurodegeneration with brain iron accumulation associated with late-onset psychiatric symptomsNeurodegeneración con acumulación cerebral de hierro asociado con síntomas psiquiátricos de inicio tardíoNeurodegeneração com acúmulo de ferro no cérebro associada a sintomas psiquiátricos de início tardioacúmulo de ferro no cérebroNBIAPKAN2neurodegenerationbrain iron accumulationNBIAPKAN2neurodegeneraciónacumulación de hierro en el cerebroNBIAPKAN2Introduction: The neurodegeneration with brain iron accumulation (NBIA) is a heterogeneous group of rare genetic disorders that lead to accumulation of iron in the basal nuclei, which leads to numerous neurologic disorders. This condition has been associated with many genes, PKAN2 being the most common. The treatment remains mostly symptomatic and the approach based on a multidisciplinary team is recommended. Case report: The case presented is from a 67-year-old male with iron accumulation bilaterally in the pale globes and has been having delirium for 8 months, as well as visuospatial and executive dysfunction and behavioral alterations. The patient's MRI showed abnormalities and the “eye of the tiger” sign. Furthemore, the treatment of choice was the administration of atypical antipsychotic medication, which partially controlled the patient's condition. Discussion: The most recurrent location of brain iron accumulation is in the basal ganglia and it is mainly linked with mutations in the pantothenate kinase 2 (PKAN2), which leads to psychiatric manifestations of insidious progression and can be inferred when the “eye of the tiger” sign is found in a MRI. Conclusion: The patient was diagnosed with late onset psychotic disorder, mild cognitive deficit and parkisonian syndrome. Genetic tests were not performed to diagnose the etiology. Therefore, the case is considered a NBIA of unknown cause with atypical characteristics and probable mutation linked to PANK2. Introducción: La neurodegeneración con acumulación de hierro en el cerebro (NBIA) es un grupo heterogéneo de trastornos genéticos raros que conducen a la acumulación de hierro en los núcleos basales, lo que conduce a numerosos trastornos neurológicos. Esta enfermedad se ha asociado a muchos genes, siendo el PKAN2 el más común. El tratamiento sigue siendo mayoritariamente sintomático y se recomienda el abordaje basado en un equipo multidisciplinar. Informe de un caso: El caso presentado es de un varón de 67 años con acumulación de hierro bilateralmente en los globos pálidos y que presenta delirio desde hace 8 meses, así como disfunción visoespacial y ejecutiva y alteraciones conductuales. La resonancia magnética del paciente mostró anomalías y el signo del "ojo del tigre". Además, el tratamiento de elección fue la administración de medicamentos antipsicóticos atípicos, que controlaron parcialmente el estado de la paciente. Discusión: La localización más recurrente de la acumulación de hierro en el cerebro es en los ganglios basales y se relaciona principalmente con mutaciones en la pantotenato quinasa 2 (PKAN2), lo que conlleva manifestaciones psiquiátricas de progresión insidiosa y puede inferirse cuando se encuentra el signo del "ojo del tigre" en una resonancia magnética. Conclusión: El paciente fue diagnosticado de trastorno psicótico de inicio tardío, déficit cognitivo leve y síndrome parkisoniano. No se realizaron pruebas genéticas para diagnosticar la etiología. Por lo tanto, el caso se considera un NBIA de causa desconocida con características atípicas y probable mutación ligada a PANK2.Introdução: A neurodegeneração com acúmulo de ferro cerebral (NBIA) é um grupo heterogêneo de doenças genéticas raras que levam ao acúmulo de ferro nos gânglios da base, levando a inúmeras desordens neurológicas. Esta doença tem sido associada a muitos genes, sendo o PKAN2 o mais comum. O tratamento continua a ser maioritariamente sintomático e recomenda-se a abordagem baseada numa equipa multidisciplinar. Relato do caso: O caso apresentado é de um homem de 67 anos com acúmulo bilateral de ferro no globo pálido e delirium há 8 meses, além de disfunção visuoespacial e executiva e distúrbios comportamentais. A ressonância magnética do paciente mostrou anormalidades e o sinal "olho de tigre". Além disso, o tratamento de escolha foi a administração de antipsicóticos atípicos, que controlavam parcialmente o quadro do paciente. Discussão: A localização mais recorrente do acúmulo de ferro no cérebro é nos gânglios da base e está relacionada principalmente a mutações na pantotenato quinase 2 (PKAN2), que leva a manifestações psiquiátricas de progressão insidiosa e pode ser inferida quando o sinal é encontrado. o "olho do tigre" em uma ressonância magnética. Conclusão: O paciente foi diagnosticado com transtorno psicótico de início tardio, déficit cognitivo leve e síndrome parkisoniana. Não foram realizados testes genéticos para diagnosticar a etiologia. Portanto, o caso é considerado um NBIA de causa desconhecida com características atípicas e provável mutação ligada a PANK2.Associação Brasileira de Psiquiatria2022-08-13info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionAvaliado pelos paresapplication/pdfhttps://revistardp.org.br/revista/article/view/38610.25118/2763-9037.2022.v12.386Debates in Psychiatry; Vol. 12 (2022); 1-11Debates em Psiquiatria; Vol. 12 (2022); 1-11Debates em Psiquiatria; v. 12 (2022); 1-112763-90372236-918Xreponame:Debates em Psiquiatria (Online)instname:Associação Brasileira de Psiquiatria (ABP)instacron:ABPenghttps://revistardp.org.br/revista/article/view/386/341Copyright (c) 2022 Júlio César Claudino dos Santos, Luiza Sarsur Ribeiro, Rafaella Iughetti da Costa, Eduardo Bordignon Peccin, Paulo Andre Pera Grabowskihttps://creativecommons.org/licenses/by-nc/4.0info:eu-repo/semantics/openAccessSantos, Júlio César Claudino dosRibeiro, Luiza SarsurCosta, Rafaella Iughetti daPeccin, Eduardo BordignonGrabowski, Paulo Andre Pera2024-01-04T23:42:10Zoai:ojs.emnuvens.com.br:article/386Revistahttps://revistardp.org.br/revista/oaiPUBhttps://revistardp.org.br/revista/oairdp@abp.org.br2763-90372236-918Xopendoar:2024-01-04T23:42:10Debates em Psiquiatria (Online) - Associação Brasileira de Psiquiatria (ABP)false |
dc.title.none.fl_str_mv |
Neurodegeneration with brain iron accumulation associated with late-onset psychiatric symptoms Neurodegeneración con acumulación cerebral de hierro asociado con síntomas psiquiátricos de inicio tardío Neurodegeneração com acúmulo de ferro no cérebro associada a sintomas psiquiátricos de início tardio |
title |
Neurodegeneration with brain iron accumulation associated with late-onset psychiatric symptoms |
spellingShingle |
Neurodegeneration with brain iron accumulation associated with late-onset psychiatric symptoms Santos, Júlio César Claudino dos acúmulo de ferro no cérebro NBIA PKAN2 neurodegeneration brain iron accumulation NBIA PKAN2 neurodegeneración acumulación de hierro en el cerebro NBIA PKAN2 |
title_short |
Neurodegeneration with brain iron accumulation associated with late-onset psychiatric symptoms |
title_full |
Neurodegeneration with brain iron accumulation associated with late-onset psychiatric symptoms |
title_fullStr |
Neurodegeneration with brain iron accumulation associated with late-onset psychiatric symptoms |
title_full_unstemmed |
Neurodegeneration with brain iron accumulation associated with late-onset psychiatric symptoms |
title_sort |
Neurodegeneration with brain iron accumulation associated with late-onset psychiatric symptoms |
author |
Santos, Júlio César Claudino dos |
author_facet |
Santos, Júlio César Claudino dos Ribeiro, Luiza Sarsur Costa, Rafaella Iughetti da Peccin, Eduardo Bordignon Grabowski, Paulo Andre Pera |
author_role |
author |
author2 |
Ribeiro, Luiza Sarsur Costa, Rafaella Iughetti da Peccin, Eduardo Bordignon Grabowski, Paulo Andre Pera |
author2_role |
author author author author |
dc.contributor.author.fl_str_mv |
Santos, Júlio César Claudino dos Ribeiro, Luiza Sarsur Costa, Rafaella Iughetti da Peccin, Eduardo Bordignon Grabowski, Paulo Andre Pera |
dc.subject.por.fl_str_mv |
acúmulo de ferro no cérebro NBIA PKAN2 neurodegeneration brain iron accumulation NBIA PKAN2 neurodegeneración acumulación de hierro en el cerebro NBIA PKAN2 |
topic |
acúmulo de ferro no cérebro NBIA PKAN2 neurodegeneration brain iron accumulation NBIA PKAN2 neurodegeneración acumulación de hierro en el cerebro NBIA PKAN2 |
description |
Introduction: The neurodegeneration with brain iron accumulation (NBIA) is a heterogeneous group of rare genetic disorders that lead to accumulation of iron in the basal nuclei, which leads to numerous neurologic disorders. This condition has been associated with many genes, PKAN2 being the most common. The treatment remains mostly symptomatic and the approach based on a multidisciplinary team is recommended. Case report: The case presented is from a 67-year-old male with iron accumulation bilaterally in the pale globes and has been having delirium for 8 months, as well as visuospatial and executive dysfunction and behavioral alterations. The patient's MRI showed abnormalities and the “eye of the tiger” sign. Furthemore, the treatment of choice was the administration of atypical antipsychotic medication, which partially controlled the patient's condition. Discussion: The most recurrent location of brain iron accumulation is in the basal ganglia and it is mainly linked with mutations in the pantothenate kinase 2 (PKAN2), which leads to psychiatric manifestations of insidious progression and can be inferred when the “eye of the tiger” sign is found in a MRI. Conclusion: The patient was diagnosed with late onset psychotic disorder, mild cognitive deficit and parkisonian syndrome. Genetic tests were not performed to diagnose the etiology. Therefore, the case is considered a NBIA of unknown cause with atypical characteristics and probable mutation linked to PANK2. |
publishDate |
2022 |
dc.date.none.fl_str_mv |
2022-08-13 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion Avaliado pelos pares |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://revistardp.org.br/revista/article/view/386 10.25118/2763-9037.2022.v12.386 |
url |
https://revistardp.org.br/revista/article/view/386 |
identifier_str_mv |
10.25118/2763-9037.2022.v12.386 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
https://revistardp.org.br/revista/article/view/386/341 |
dc.rights.driver.fl_str_mv |
https://creativecommons.org/licenses/by-nc/4.0 info:eu-repo/semantics/openAccess |
rights_invalid_str_mv |
https://creativecommons.org/licenses/by-nc/4.0 |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Associação Brasileira de Psiquiatria |
publisher.none.fl_str_mv |
Associação Brasileira de Psiquiatria |
dc.source.none.fl_str_mv |
Debates in Psychiatry; Vol. 12 (2022); 1-11 Debates em Psiquiatria; Vol. 12 (2022); 1-11 Debates em Psiquiatria; v. 12 (2022); 1-11 2763-9037 2236-918X reponame:Debates em Psiquiatria (Online) instname:Associação Brasileira de Psiquiatria (ABP) instacron:ABP |
instname_str |
Associação Brasileira de Psiquiatria (ABP) |
instacron_str |
ABP |
institution |
ABP |
reponame_str |
Debates em Psiquiatria (Online) |
collection |
Debates em Psiquiatria (Online) |
repository.name.fl_str_mv |
Debates em Psiquiatria (Online) - Associação Brasileira de Psiquiatria (ABP) |
repository.mail.fl_str_mv |
rdp@abp.org.br |
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1796798365301735424 |