一名肾病综合征患儿的类固醇诱发精神病：病例报告。
Steroid induced psychosis in a child with nephrotic syndrome: A case report.
作者信息
Bhusal Amrit, Bhandari Silan, Pokhrel Sagar, Yadav Shankar Prasad
机构信息
BP Koirala Institute of Health Sciences, Nepal.
Pediatric Nephrologist, Department of Pediatrics and Adolescent Medicine, BP Koirala Institute of Health Sciences, Nepal.
出版信息
Ann Med Surg (Lond). 2022 Aug 24;81:104515. doi: 10.1016/j.amsu.2022.104515. eCollection 2022 Sep.
BACKGROUND
and Importance: Steroids induced psychosis is one of major adverse effects of corticosteroids therapy especially in patients with disease causing low serum albumin level like nephrotic syndrome. The literature review about this adverse effects is lesser in children than adults population. The management is done by tapering dose of steroids in aid of immunosuppressive drug with an antipsychotics drug.
CASE PRESENTATION
Here we present a case of 14 years old female child known case of nephrotic syndrome secondary to Focal segmental glomerulosclerosis with steroids induced psychosis who is managed by tapering dose of prednisolone with Tacrolimus as immunosuppressive and Quetiapine as antipsychotic.
CONCLUSION
The prevalence of steroids induced psychosis is higher in our locality which is still unreported due to lack of detailed history and proper diagnosis and it is manageable if early diagnosis and treatment is initiated. Thus, proper counselling to parents about the adverse effect of steroids therapy and timely follow up will prevent Nepalese children from this illness.
背景与重要性
类固醇诱导的精神病是皮质类固醇治疗的主要不良反应之一，尤其是在患有导致血清白蛋白水平降低的疾病（如肾病综合征）的患者中。关于这种不良反应的文献综述在儿童中比在成人中少。治疗方法是逐渐减少类固醇剂量，并辅助使用免疫抑制药物和抗精神病药物。
病例介绍
我们在此介绍一名14岁女童，她是局灶节段性肾小球硬化继发肾病综合征的已知病例，并患有类固醇诱导的精神病，通过逐渐减少泼尼松龙剂量，同时使用他克莫司作为免疫抑制剂和喹硫平作为抗精神病药物进行治疗。
结论
在我们当地，类固醇诱导的精神病患病率较高，由于缺乏详细病史和正确诊断，这一情况仍未得到报告。如果能早期诊断并开始治疗，这种情况是可以控制的。因此，向家长提供关于类固醇治疗不良反应的适当咨询以及及时随访，将使尼泊尔儿童预防这种疾病。
Zotero 插件