Briegel Wolfgang
Klinik für Kinder- und Jugendpsychiatrie und Psychotherapie, Leopoldina-Krankenhaus, Schweinfurt.
Z Kinder Jugendpsychiatr Psychother. 2007 Sep;35(5):353-7; quiz 357-8. doi: 10.1024/1422-4917.35.5.353.
22q11.2 deletion is the most common microdeletion in humans and one of the most important risk factors for schizophrenia. Nevertheless, case reports of children or adolescents with 22q11.2 deletion and schizophrenia are very rare. After a review of the current knowledge about physical, developmental, behavioural and psychiatric problems in 22q11.2 deletion, the case of a 12;10-year-old boy with schizophrenia and the microdeletion is reported. About three years after the first symptoms, and only after medication with several neuroleptics, the patient reached his pre-morbid functioning level under treatment with risperidone. Under medication with clozapine he had experienced a single event of seizures which were due to hypocalcemia. This case report illustrates the importance of serum calcium controls at regular intervals for patients with 22q11.2 deletion and schizophrenia who are on neuroleptic medication. Ideally, children and adolescents with the deletion and co-morbid psychiatric problems should be treated in child and adolescent psychiatry units specialized in problems associated with the deletion. A good cooperation with other medical services is absolutely necessary.
22q11.2缺失是人类最常见的微缺失,也是精神分裂症最重要的风险因素之一。然而,关于患有22q11.2缺失和精神分裂症的儿童或青少年的病例报告非常罕见。在回顾了当前有关22q11.2缺失的身体、发育、行为和精神问题的知识后,报告了一例患有精神分裂症和该微缺失的12岁男孩的病例。在出现最初症状约三年后,且仅在使用多种抗精神病药物治疗后,该患者在使用利培酮治疗下恢复到病前功能水平。在使用氯氮平治疗期间,他曾因低钙血症发生过一次癫痫发作。本病例报告说明了对于正在接受抗精神病药物治疗的22q11.2缺失和精神分裂症患者定期进行血清钙检查的重要性。理想情况下,患有该缺失和共病精神问题的儿童和青少年应在专门处理与该缺失相关问题的儿童和青少年精神科病房接受治疗。与其他医疗服务部门进行良好合作绝对必要。