Malaty Giovanni, Godbe Kerilyn, Elmouchtari Mehdi, Malhi Gurjot, White Justin, Bankole Azziza, Criss Tracey
Virginia Tech Carilion School of Medicine, 2 Riverside Cr, Roanoke, VA 24016, USA.
Carilion Clinic Psychiatry & Behavioral Medicine, 2017 S Jefferson St, Roanoke, VA 24014, USA.
Case Rep Psychiatry. 2020 Oct 30;2020:8889883. doi: 10.1155/2020/8889883. eCollection 2020.
The safety and efficacy of electroconvulsive therapy (ECT) for the treatment of psychiatric disorders have been demonstrated in a wide variety of patients, including postoperative patients and those who are pregnant. While several reports highlight the safety of this treatment in heart and liver transplantation patients, there is a relative lack of literature detailing the safety profile of ECT in an individual with recent kidney transplantation. Here, we explore the case of a patient with a recent renal transplant secondary to diabetes-related end-stage renal disease (ESRD) who underwent a successful course of ECT treatment. A 57-year-old Caucasian male with a past psychiatric history of schizoaffective disorder, bipolar type, and a past medical history of end-stage renal disease with recent right renal transplantation was admitted to the inpatient psychiatry unit. The admission was via a temporary detention order (TDO) for suicidality and auditory hallucinations promoting self-harm. The patient's depressive and delusional history was well-documented and had been refractory to several courses of psychotherapeutic and pharmacologic management. Electroconvulsive therapy was subsequently initiated and was well-tolerated. Treatments progressively alleviated his depressive and psychotic symptoms and did not adversely affect the function of his transplanted kidney, which was closely monitored throughout the treatment process. This case demonstrated the safety and efficacy of ECT treatment in an individual with recent renal transplant and may prompt further trials into establishing safety and efficacy in larger study populations.
电休克疗法(ECT)治疗精神疾病的安全性和有效性已在包括术后患者和孕妇在内的各类患者中得到证实。虽然有几份报告强调了这种治疗方法在心脏和肝脏移植患者中的安全性,但相对缺乏详细描述近期肾移植个体中ECT安全性的文献。在此,我们探讨了一名因糖尿病相关终末期肾病(ESRD)近期接受肾移植的患者成功接受ECT治疗的病例。一名57岁的白人男性,既往有双相型分裂情感障碍的精神病史,以及终末期肾病并近期接受右肾移植的病史,入住了精神科住院病房。此次入院是通过临时拘留令(TDO),原因是有自杀倾向和幻听促使其自我伤害。该患者的抑郁和妄想病史记录详尽,并且对几个疗程的心理治疗和药物治疗均无效。随后启动了电休克疗法,患者耐受性良好。治疗逐渐减轻了他的抑郁和精神病症状,并且未对其移植肾的功能产生不利影响,在整个治疗过程中对移植肾进行了密切监测。该病例证明了ECT治疗在近期肾移植个体中的安全性和有效性,可能会促使开展进一步试验以确定在更大研究人群中的安全性和有效性。