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首页> 外文期刊>Psychosomatic Medicine: Journal of the American Psychosomatic Society >Obsessive-compulsive behavior as presenting symptom of primary antiphospholipid syndrome
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Obsessive-compulsive behavior as presenting symptom of primary antiphospholipid syndrome

机译：强迫行为表现为原发性抗磷脂综合征的症状

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OBJECTIVE: This study aimed to improve understanding and treatment of psychiatric symptoms in antiphospholipid syndrome (APS) and to present an approach to the medical management of patients presenting with obsessive-compulsive disorder (OCD) with suspected neurovascular pathology. METHOD: A 15-year-old boy presented with severe OCD of recent onset. An infarct of the caudate nucleus was identified as the initial presentation of primary APS. This case report includes a selective literature review of the neuropsychiatric correlates of APS. RESULTS: The patient had OCD for 3 months with increasing symptoms resulting in admission for psychiatric reasons. After referral to the emergency department 3 weeks later, an infarct of the caudate nucleus was documented using magnetic resonance images of the brain, and APS was diagnosed based on additional laboratory findings. Anticoagulant treatment (enoxaparin and phenprocoumon) in this patient was effective in reducing obsessive-compulsive symptom severity. CONCLUSION: OCD may present as a neuropsychiatric manifestation of APS. The present observations are consistent with a thrombotic mechanism for neurologic or psychiatric symptoms in APS. In general, routine medical workup for childhood OCD is not indicated, but a comprehensive psychiatric, medical, and family history taking and physical examination are essential, particularly if OCD is of recent onset. The role of anticoagulant therapy in neuropsychiatric manifestations of APS without the presence of a cerebral infarct requires further research.
机译：目的：本研究旨在增进对抗磷脂综合征（APS）精神症状的理解和治疗，并提出一种对患有强迫症（OCD）且疑似神经血管病理的患者进行医疗管理的方法。方法：一名15岁男孩近期发作严重OCD。尾状核梗死被确定为原发性APS的最初表现。该病例报告包括对APS的神经精神相关性的选择性文献综述。结果：患者患有强迫症3个月，症状增加，由于精神原因入院。 3周后转诊至急诊科，使用大脑的磁共振图像记录了尾状核梗塞，并根据其他实验室检查结果诊断出APS。该患者的抗凝治疗（依诺肝素和苯普鲁蒙）可有效降低强迫症症状的严重程度。结论：强迫症可以作为APS的神经精神表现。目前的观察结果与APS中神经或精神症状的血栓形成机制一致。通常，没有指示对儿童强迫症进行常规医学检查，但是全面的精神病学，医学和家族史检查以及体格检查是必不可少的，特别是如果强迫症是近期发作的话。在没有脑梗塞的情况下，抗凝治疗在APS的神经精神病学表现中的作用需要进一步研究。

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