与丙型肝炎抗病毒治疗相关的偏执型精神病和认知障碍。

Paranoid psychosis and cognitive impairment associated with hepatitis C antiviral therapy.

机构信息

Department of Psychiatry and Behavioural Neurosciences, St. Joseph's Hospital, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada.

出版信息

Gen Hosp Psychiatry. 2014 Jan-Feb;36(1):126.e3-5. doi: 10.1016/j.genhosppsych.2013.10.008. Epub 2013 Oct 14.

DOI:10.1016/j.genhosppsych.2013.10.008

PMID:24210465

Abstract

OBJECTIVE

To report a case of paranoid psychosis and cognitive impairment associated with Hepatitis C virus (HCV) antiviral therapy.

METHODS

Case report.

RESULTS

A 55-year-old male presented with paranoid psychosis and cognitive impairment, 4 months after initiating interferon-based HCV antiviral therapy. His psychosis resolved with discontinuation of therapy and initiation of risperidone, but his cognitive impairment persisted. His psychosis also re-emerged months later when attempting to titrate down his risperidone. Brain MRI demonstrated bilateral asymmetric subcortical and deep white matter changes, which were non-specific but may have rendered him susceptible to neuropsychiatric sequelae of antiviral therapy.

CONCLUSION

This case emphasizes the importance of neuropsychiatric screening and monitoring of patients being treated with interferon-based therapy for HCV, particularly if there is evidence of previous neurologic disease.

摘要

目的

报告 1 例与丙型肝炎病毒（HCV）抗病毒治疗相关的偏执型精神病和认知障碍。

方法

病例报告。

结果

1 名 55 岁男性在开始基于干扰素的 HCV 抗病毒治疗 4 个月后出现偏执型精神病和认知障碍。停用治疗药物并开始使用利培酮后，其精神病得到缓解，但认知障碍仍持续存在。数月后，当试图逐渐减少利培酮剂量时，他的精神病再次出现。脑部 MRI 显示双侧非对称皮质下和深部白质改变，无特异性，但可能使他易患抗病毒治疗的神经精神后遗症。