title: A case of Gorlin-Goltz syndrome presented with psychiatric features.
abstract: We report a case of a 34-year-old male who presented with an acute onset of pleomorphic psychiatric features. Upon examination we later diagnosed him with Gorlin-Goltz syndrome based on clinical and radiological findings that are characteristic for this rare autosomal dominant syndrome. His psychiatric manifestations included irritability, aggressive behavior, labile mood, hallucinations, paranoid delusions, and transient cognitive impairment. His past history indicated surgical excision of pigmented lesion in the left lower eyelid which turned out to be a basal cell carcinoma. His past visits to dermatology clinics indicated pitted keratosis involving hands, callosities, and seborrheic dermatitis. There were numerous palmar pits, and Brain CT Head scan revealed extensive calcification along falx cerebri and around the cerebellar vermis. He had low (20 ng/L) vitamin D level and high parathyroid hormone level. The patient improved using antipsychotic medications and vitamin D supplementations for symptomatic management and was discharged with a plan for multispecialty outpatient follow-up. This case highlights the importance of considering rare organic etiologies in the differential diagnosis of patients presenting with psychiatric symptoms. This is of vital importance for early intervention to prevent complications and for better outcomes of the coexistent diseases.
authors.affiliation: Community Mental Health Services, Behavioral Sciences Institute, Al Ain Hospital, P.O. Box 1006, Al Ain, United Arab Emirates ; Behavioral Sciences Institute, Al Ain Hospital, Al Ain, United Arab Emirates.
authors.forename: Amir
authors.identifier: 0000-0002-7981-9881
authors.initials: A
authors.lastname: Mufaddel
authors.affiliation: Behavioral Sciences Institute, Al Ain Hospital, Al Ain, United Arab Emirates.
authors.forename: Mouza
authors.initials: M
authors.lastname: Alsabousi
authors.affiliation: Behavioral Sciences Institute, Al Ain Hospital, Al Ain, United Arab Emirates.
authors.forename: Badr
authors.initials: B
authors.lastname: Salih
authors.affiliation: Behavioral Sciences Institute, Al Ain Hospital, Al Ain, United Arab Emirates.
authors.forename: Ghanem
authors.initials: G
authors.lastname: Alhassani
authors.affiliation: College of Medicine and Health Sciences, United Arab Emirates University, P.O. Box 17666, Al Ain, United Arab Emirates.
authors.forename: Ossama T
authors.initials: OT
authors.lastname: Osman
mesh_terms: D000328:Adult; D001478:Basal Cell Nevus Syndrome / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging; D001921:Brain / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D011618:Psychotic Disorders / Q000150:complications* / Q000000981:diagnostic imaging; D011859:Radiography