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Bipolar disorder and Susac syndrome: a case report.
Gutiérrez-Arango, Felipe; Anmella, Gerard; Hidalgo-Mazzei, Diego; Gomes-da-Costa, Susana; Gil-Badenes, Joaquín; Marco-Hernández, Javier; Espinosa, Gerard; Colomer, Lluc; Baldaquí, Nuria; Pujal, Ester; Fico, Giovanna; Giménez, Anna; Verdolini, Norma; Murru, Andrea; Vieta, Eduard; Pacchiarotti, Isabella.
Afiliación
  • Gutiérrez-Arango F; Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM.
  • Anmella G; Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM.
  • Hidalgo-Mazzei D; Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM.
  • Gomes-da-Costa S; Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM.
  • Gil-Badenes J; Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM.
  • Marco-Hernández J; Autoimmune Diseases Department, Institut d'Investigacions August Pi i Sunyer, Universitat de Barcelona, Hospital Clinic, Barcelona, Catalonia, Spain.
  • Espinosa G; Autoimmune Diseases Department, Institut d'Investigacions August Pi i Sunyer, Universitat de Barcelona, Hospital Clinic, Barcelona, Catalonia, Spain.
  • Colomer L; Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM.
  • Baldaquí N; Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM.
  • Pujal E; Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM.
  • Fico G; Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM.
  • Giménez A; Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM.
  • Verdolini N; Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM.
  • Murru A; Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM.
  • Vieta E; Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM.
  • Pacchiarotti I; Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM.
Int Clin Psychopharmacol ; 36(6): 305-309, 2021 11 01.
Article en En | MEDLINE | ID: mdl-34270507
Susac-syndrome is a rare autoimmune disease that manifests with mood alterations in up to 15% of cases and is usually treated with corticosteroids. We present the case of a 41-year-old woman with a first manic episode and history of Susac-syndrome, secondary Cushing's syndrome after receiving high doses of corticosteroids and a previous depressive episode. Differentiating between primary and secondary mania is difficult, as people with bipolar disorder are prone to multiple psychiatric and nonpsychiatric comorbidities, in this case, the differential diagnosis included secondary mania, corticoid-induced manic episode and primary bipolar disorder. Upon admission, corticosteroid treatment was suspended, and the patient was started on lithium and risperidone. Secondary causes of mania were discarded and, assessing temporal and dosage criteria, it was deemed unlikely that the present episode was corticosteroid-induced. One-year outpatient follow-up pointed towards a primary bipolar type I disorder, as a separate entity from her Susac-syndrome. Corticosteroid use or abrupt withdrawal pose an underestimated risk of inducing depressive or manic symptoms, which may unmask affective disorders in susceptible individuals. Many medical conditions share CNS involvement and/or high-dose/prolonged corticosteroid treatment. In such cases, psychiatric manifestations such as mania or depression should be regarded as secondary and studied to determine the existence of medical complications before considering primary psychiatric conditions.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Trastorno Bipolar / Síndrome de Susac Tipo de estudio: Diagnostic_studies Límite: Adult / Female / Humans Idioma: En Revista: Int Clin Psychopharmacol Asunto de la revista: PSICOFARMACOLOGIA Año: 2021 Tipo del documento: Article Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Trastorno Bipolar / Síndrome de Susac Tipo de estudio: Diagnostic_studies Límite: Adult / Female / Humans Idioma: En Revista: Int Clin Psychopharmacol Asunto de la revista: PSICOFARMACOLOGIA Año: 2021 Tipo del documento: Article Pais de publicación: Reino Unido