title: Psychosis in an adolescent with Wilson's disease: A case report and review of the literature.
abstract: Neuropsychiatric manifestations are common in Wilson's disease and mainly include extrapyramidal and cerebellar symptoms. Presentations with psychotic symptoms have been described less frequently. In this report we present the case of a young boy with Wilson's disease who developed psychotic symptoms. A 12-year-old boy was diagnosed with Wilson's disease on the basis of the physical examination findings and low ceruloplasmin levels (8.1 mg/dl). After 2 weeks of being diagnosed with Wilson's disease, he developed an acute onset illness, characterized by delusion of persecution, fearfulness, hypervigilence and decreased sleep. These symptoms were not associated with any confusion, clouding of consciousness, hallucinations and affective symptoms. There was no past or family history of psychosis. One week after the onset of the symptoms he was prescribed tab penicillamine, initially 250 mg/day, which was increased to 500 mg/day after 3 days. After increase in the dose of penicillamine, his psychiatric symptoms worsened and led to hospitalization. A diagnosis of organic delusional disorder (F06.2) due to Wilson's disease was considered. Tab risperidone 1 mg/day was started, and the dose of penicillamine was reduced with which symptoms resolved. Whenever a young adolescent develops psychosis, especially of delusional type, the possibility of Wilson's disease must be considered.
authors.affiliation: Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Sandeep
authors.initials: S
authors.lastname: Grover
authors.affiliation: Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Siddharth
authors.initials: S
authors.lastname: Sarkar
authors.affiliation: Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Soumya
authors.initials: S
authors.lastname: Jhanda
authors.affiliation: Department of Hepatology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Yogesh
authors.initials: Y
authors.lastname: Chawla
keywords: Psychosis; Wilson's disease; adolescent