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Acute psychosis in propionic acidemia: 2 case reports.
C Dejean de la Bâtie1, V Barbier, V Valayannopoulos
11Service de Pédopsychiatrie, Hôpital Necker-Enfants Malades, APHP, Université Paris Descartes, Paris, France.
Journal of Child Neurology
|December 17, 2013
Summary
Propionic acidemia, a metabolic disorder, can manifest as acute psychotic episodes in adolescents. These episodes, characterized by hallucinations and disorganized behavior, may require psychiatric intervention and careful management of co-occurring conditions.
Area of Science:
- Biochemistry
- Neurology
- Psychiatry
Background:
- Propionic acidemia is an inherited metabolic disorder affecting propionyl-CoA carboxylase activity.
- It leads to the accumulation of toxic by-products in mitochondria.
- Neurologic complications are common, but psychiatric manifestations are rarely reported.
Observation:
- Two pediatric cases with chronic psychiatric symptoms presented with acute psychotic episodes during adolescence.
- Symptoms included hallucinations, panic attacks, and disorganized behavior lasting weeks to months.
- Patients exhibited moderate metabolic decompensation coinciding with the onset of psychiatric symptoms.
Findings:
- Psychiatric symptoms persisted beyond the period of metabolic imbalance.
- The study suggests propionic acidemia as a potential contributing factor to these psychotic episodes.
- These episodes necessitate psychiatric evaluation and tailored antipsychotic treatment.
Implications:
- Highlights the importance of considering metabolic disorders like propionic acidemia in adolescent-onset psychosis.
- Emphasizes the need for psychiatric care and management of potential cardiac complications (cardiomyopathy, long QT syndrome) in affected individuals.
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