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自身免疫性精神病作为儿童和青少年原发性精神分裂症样精神病的鉴别诊断

Autoimmune Psychosis as a Differential Diagnosis of Primary Schizophreniform Psychosis in Children and Adolescents.

作者信息

Briegel Wolfgang, Wößner Rupert, Trollmann Regina

机构信息

Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Leopoldina Hospital, Schweinfurt, Germany.

Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Center for Mental Health, University Hospital of Würzburg, Germany.

出版信息

Z Kinder Jugendpsychiatr Psychother. 2025;53(3):166-172. doi: 10.1024/1422-4917/a001003. Epub 2024 Dec 5.

Abstract

Autoimmune psychosis (AP), defined as an isolated schizophreniform psychosis with no or only minimal neurological abnormalities stemming from autoantibody-associated cerebral processes, is a very rare and potentially underdiagnosed disorder in children and adolescents. This article reports the case of a 13-year-old boy who became acutely ill with a psychotic disorder following a respiratory infection. We describe the diagnosis and course of treatment in detail. Following an extensive interdisciplinary workup, a probable glutamic acid decarboxylase (GAD)-associated AP was diagnosed that ultimately remitted completely with treatment. Autoimmune psychoses remain a relatively uncharted territory for the specialty of child and adolescent psychiatry. Good interdisciplinary cooperation is essential for patients with somewhat atypical psychotic symptoms, both in terms of diagnosis and treatment.

摘要

自身免疫性精神病(AP)被定义为一种孤立的精神分裂症样精神病,源于自身抗体相关的大脑病变,无神经学异常或仅有轻微神经学异常,这在儿童和青少年中是一种非常罕见且可能未被充分诊断的疾病。本文报告了一名13岁男孩的病例,该男孩在呼吸道感染后突发精神障碍。我们详细描述了诊断和治疗过程。经过广泛的多学科检查,诊断出可能与谷氨酸脱羧酶(GAD)相关的AP,最终经治疗完全缓解。自身免疫性精神病在儿童和青少年精神病学领域仍是一个相对未知的领域。对于有某些非典型精神病症状的患者,无论是在诊断还是治疗方面,良好的多学科合作都是至关重要的。

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