Liver transplantation in a patient with undiagnosed bipolar disorder.
We present the case of a 55-year-old woman with no previous diagnosis of bipolar disorder, who underwent orthotopic liver transplantation for hepatitis C and alcohol-related liver disease. Two weeks posttransplant, she exhibited manic symptoms including hyperactivity, racing thoughts, and pressured speech. Although drug and alcohol abuse had been in remission for a 10-year period, a long history consistent with bipolar disorder was only identified after surgery. This article discusses the role of psychiatric evaluation prior to undergoing liver transplantation, and provides the transplant team with suggestions for comprehensively assessing psychiatric disorders in addition to alcohol and drug use.
Mamah
D
D
Department of Psychiatry, Washington University School of Medicine, St. Louis, MO 63110, USA. mamahd@psychiatry.wustl.edu
Hong
B A
BA
Chapman
W C
WC
D001714:Bipolar Disorder / Q000150:complications* / Q000188:drug therapy; D005260:Female; D006526:Hepatitis C / Q000150:complications / Q000601:surgery*; D006801:Humans; D008108:Liver Diseases, Alcoholic / Q000601:surgery*; D016031:Liver Transplantation; D008140:Lorazepam / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D035781:Siblings
D008140:Lorazepam