title: Autistic-like findings associated with a urea cycle disorder in a 4-year-old girl.
abstract: A 4-year-old girl presented at our clinic with autistic-like symptoms, aggressivity and occasional hyperactivity. She had no history of neurologic or physical symptoms. Her condition was diagnosed as pervasive developmental disorder not otherwise specified, according to the criteria of the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV). She received pharmacologic (thioridazine), educational and speech therapy. During this process, a urea cycle disorder was also identified, namely, ornithine transcarbamylase deficiency and arginase deficiency, because of the high level of ammonia in the patient's bloodstream, the high level of organic acids in the 24-hour urine collection and the constant presence of slow multifocal epileptic discharges on the electroencephalograms. The patient's protein intake was restricted, and she was treated with sodium benzoate and arginine. After 1 year of treatment, the autistic-like findings and hyperactivity were no longer apparent.
authors.affiliation: Department of Child and Adolescent Psychiatry, Faculty of Medicine, Istanbul University, Istanbul, Turkey. i.gorker@superonline.com
authors.forename: Işik
authors.initials: I
authors.lastname: Görker
authors.forename: Umran
authors.initials: U
authors.lastname: Tüzün
mesh_terms: D001321:Autistic Disorder / Q000523:psychology*; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008661:Metabolism, Inborn Errors / Q000523:psychology* / Q000628:therapy*; D014508:Urea / Q000378:metabolism*
chemical_list: D014508:Urea