Catatonia Induced by an ACTH-Secreting Neuroendocrine Tumor: A Case Report
Objective: The catatonic reaction is a striking syndrome associated with a variety of psychiatric and medical conditions, including high-dose corticosteroid therapy. We present the case of a patient who suffered increasing mental disturbance to the point of catatonia in the setting of an adrenocorti...
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Published in | AACE clinical case reports Vol. 1; no. 4; pp. e245 - e249 |
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Main Authors | , , , |
Format | Journal Article |
Language | English |
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Elsevier
01.01.2015
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Abstract | Objective: The catatonic reaction is a striking syndrome associated with a variety of psychiatric and medical conditions, including high-dose corticosteroid therapy. We present the case of a patient who suffered increasing mental disturbance to the point of catatonia in the setting of an adrenocorticotropic hormone (ACTH)-secreting neuroendocrine tumor and severe hypercortisolism. We describe the presentation and course of treatment with benzodiazepines and pancreaticoduodenectomy.Methods: A PubMed literature search was done to summarize and compare this case to other reported cases of psychiatric disturbances in the setting of hypercortisolism.Results: Our literature review of case reports from 1952–2011 noted 7 cases of catatonic reactions to glucocorticoid or ACTH administration. We hypothesize that the catatonia in our patient was caused by elevated levels of cortisol secondary to ectopic ACTH overproduction, making this report the first documented case of catatonia secondary to an ACTH-secreting neuroendocrine tumor.Conclusion: Catatonia is a rare clinical presentation of an ACTH-secreting neuroendocrine tumor, which can be successfully controlled with benzodiazepines and definitively treated with pancreaticoduodenectomy.Abbreviations: ACTH adrenocorticotropic hormone CT computed tomography ECT electroconvulsive therapy NMDA N-methyl-D-aspartate POD postoperative day |
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AbstractList | Objective: The catatonic reaction is a striking syndrome associated with a variety of psychiatric and medical conditions, including high-dose corticosteroid therapy. We present the case of a patient who suffered increasing mental disturbance to the point of catatonia in the setting of an adrenocorticotropic hormone (ACTH)-secreting neuroendocrine tumor and severe hypercortisolism. We describe the presentation and course of treatment with benzodiazepines and pancreaticoduodenectomy.Methods: A PubMed literature search was done to summarize and compare this case to other reported cases of psychiatric disturbances in the setting of hypercortisolism.Results: Our literature review of case reports from 1952–2011 noted 7 cases of catatonic reactions to glucocorticoid or ACTH administration. We hypothesize that the catatonia in our patient was caused by elevated levels of cortisol secondary to ectopic ACTH overproduction, making this report the first documented case of catatonia secondary to an ACTH-secreting neuroendocrine tumor.Conclusion: Catatonia is a rare clinical presentation of an ACTH-secreting neuroendocrine tumor, which can be successfully controlled with benzodiazepines and definitively treated with pancreaticoduodenectomy.Abbreviations: ACTH adrenocorticotropic hormone CT computed tomography ECT electroconvulsive therapy NMDA N-methyl-D-aspartate POD postoperative day |
Author | Dong, Tien Sy Pannain, Silvana Henry, Jonathan Thompson Stanley, Katherine |
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Cites_doi | 10.1056/NEJM195202072460601 10.1002/cpt1972135part1694 10.1001/archgenpsychiatry.2009.141 10.1001/jama.1950.02910420008003 10.1093/oxfordjournals.schbul.a007088 10.1016/j.jpsychires.2008.08.005 10.1177/089198878900200108 10.1093/qjmed/89.7.543 10.1176/ajp.142.8.911 10.1097/JCP.0b013e3181c9bfe6 10.1007/PL00014200 10.1007/s11920-010-0113-y 10.3109/00048679609076085 10.1038/nrn2639 10.1056/NEJM195307302490502 10.1192/bjp.158.1.125 10.1097/01.pra.0000428562.86705.cd 10.1111/j.1749-6632.2002.tb04419.x 10.1542/peds.63.4.677 |
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