Atypical Psychiatric Manifestation of Primary Wilson\'s Disease: A Case Report

M Subramanyam; Sanjiv Chamraj; Khushboo Dewani; Preeti Srinivasa

doi:10.5005/jp-journals-10067-0096

SEARCH WITHIN CONTENT

Online First

Atypical Psychiatric Manifestation of Primary Wilson\'s Disease: A Case Report

M Subramanyam, Sanjiv Chamraj, Khushboo Dewani, Preeti Srinivasa

Keywords : Bipolar affective disorder, Extrapyramidal side effects, Irritability, Rigidity, Tremors

Citation Information : Subramanyam M, Chamraj S, Dewani K, Srinivasa P. Atypical Psychiatric Manifestation of Primary Wilson\'s Disease: A Case Report. Ind J Priv Psychiatry 2022; 16 (1):34-37.

DOI: 10.5005/jp-journals-10067-0096

License: CC BY-NC 4.0

Published Online: 16-03-2022

ARTICLE
REFERENCES

Abstract

Background: Wilson\'s disease (WD) is an autosomal recessive disorder of copper metabolism. It is associated with ATP7B gene mutations, present on chromosome 13. It is primarily a liver disease, but presentation varies according to copper deposition in various organs. The diagnosis depends on clinical features, Kayser–Fleischer rings, biochemical parameters, radiological findings, liver biopsy, and gene analysis. Case: We report an atypical presentation of WD, where the patient presented with only psychiatric manifestations with two episodes of mania with duration of 3 years to evolve from psychiatric manifestations to neurological and hepatic manifestations of WD. Conclusion: A high index of suspicion is required, and early recognition of atypical presentation and initiation of the treatment can prevent a catastrophic outcome.

PDF Share

Frydman M, Bonne-Tamir B, Farrer LA, et al. Assignment of the gene for Wilson disease to chromosome 13: linkage to esterase D locus. Proc Natl Acad Sci USA 1985;82(6):1819–1821. DOI: 10.1073/pnas.82.6.1819.
Coffey AJ, Durkie M, Hague S, et al. A genetic study of Wilson's disease in the United Kingdom. Brain 2013;136(Pt 5):1476–1487. DOI: 10.1093/brain/awt035.
Taly AB, Prashanth LK, Sinha S. Wilson's disease: an Indian perspective. Neurol India 2009;57(5):528–540. DOI: 10.4103/0028-3886.57789.
Litwin T, Dusek P, Szafrański T, et al. Psychiatric manifestations in Wilson's disease: possibilities and difficulties for treatment. Ther Adv Psychopharmacol 2018;8(7):199–211. DOI: 10.1177/2045125318759461.
Ala A, Walker AP, Ashkan K, et al. Wilson's disease. Lancet 2007;369(9559):397–408. DOI: 10.1016/S0140-6736(07)60196-2.
Kumar MK, Kumar V, Singh PK. Wilson's disease with neurological presentation, without hepatic involvement in two siblings. J Clin Diagn Res 2013;7(7):1476–1478. DOI: 10.7860/JCDR/2013/5974.3188.
Sahoo MK, Avasthi A, Sahoo M, et al. Psychiatric manifestations of Wilson's disease and treatment with electroconvulsive therapy. Indian J Psychiatry 2010;52(1):66–68. DOI: 10.4103/0019-5545.58898.

PDF Share