ABSTRACT
Relapsing polychondritis is a rare, multisystem autoimmune disease. It is characterized by recurrent inflammation of the cartilage and connective tissues in the body. In this paper, we described a case of relapsing polychondritis initially presented symptoms of cognitive dysfunction and personality changes. A 63-year-old male reprented fever, cognitive impairment and personality changes. Brain magnetic resonance imaging revealed leptomeningeal and periauricular hyperintensities. A cerebrospinal fluid examination showed aseptic meningitis. As he reprented hearing difficulties, audiometry showed the sensory neural hearing loss. On physical examination, erythematous swollen auricles were noted. Auricle biopsy consisted with inflammation with perichondritis. He was diagnosed with relapsing polychondritis accompanied by leptomeningeal meningitis, and treated with methylprednisolone (62.5 mg/day for 3 days) followed by prednisolone 60 mg/day and methotrexate 7.5 mg/week. Fever and painful swellings on the both ears subsided. He showed improvement in cognitive function and personality. Although relapsing polychondritis is rare, it should be considered to be a possible cause of leptomeningeal meningitis.
Subject(s)
Humans , Male , Middle Aged , Audiometry , Autoimmune Diseases , Biopsy , Brain , Cartilage , Cerebrospinal Fluid , Cognition , Cognition Disorders , Connective Tissue , Ear , Fever , Hearing , Hearing Loss , Inflammation , Magnetic Resonance Imaging , Meningitis , Meningitis, Aseptic , Methotrexate , Methylprednisolone , Physical Examination , Polychondritis, Relapsing , PrednisoloneABSTRACT
PURPOSE: Few reports have documented psychopathological abnormalities in patients with primary spontaneous pneumothorax (PSP). We analyzed the results of a multiphasic personal inventory test to investigate the psychopathologic impact of PSP in young Korean males. MATERIALS AND METHODS: The authors reviewed the results of a Korean military multiphasic personal inventory (KMPI) administered to military conscripts in South Korea. A total of 234 young males participated in this study. The normal volunteer group (n=175) comprised individuals who did not have any lung disease. The PSP group (n=59) included individuals with PSP. None of the examinees had any psychological problems. The KMPI results of both groups were compared. RESULTS: There were more abnormal responses in the PSP group (17.0%) than the normal volunteer group (9.1%, p=0.002). The anxiety scale and depression scale scores of the neurosis category were greater for the PSP group than the normal group (p=0.039 and 0.014, respectively). The personality disorder and paranoia scale scores of the psychopathy category were greater for the PSP group than the normal group (p=0.007 and 0.018, respectively). CONCLUSION: Young males with PSP may have greater tendencies to suffer from anxiety, depression, personality disorders, and paranoia compared to normal individuals. Clinicians should be advised to evaluate the psychopathological aspects of patients with PSP.
Subject(s)
Humans , Male , Anxiety , Depression , Healthy Volunteers , Korea , Lung Diseases , Military Personnel , Paranoid Disorders , Personality Disorders , Pneumothorax , PsychopathologyABSTRACT
OBJETIVO: Avaliar traços de personalidade e suas alterações em pacientes do sexo feminino com Lúpus Eritematoso Sistêmico (LES), procurando relacionar mudanças na atividade da doença com alterações nos traços de personalidade dessas pacientes. PACIENTES E MÉTODOS: Foram selecionadas 20 pacientes do Ambulatório de Reumatologia do Hospital Universitário da Universidade Federal de Mato Grosso do Sul (UFMS). Após a avaliação inicial, elas foram reavaliadas em três e em seis meses, em relação à presença de Transtornos Psiquiátricos (particularmente alterações da personalidade) e atividade do lúpus. Além das avaliações clínicas psiquiátricas e reumatológicas, as escalas utilizadas para avaliação das pacientes foram a Escala Fatorial de Ajustamento Emocional/Neuroticismo (EFN) e a Systemic Lupus Erythematosus Disease Activity Index (SLEDAI). RESULTADOS: Em todos os tempos analisados não houve relação significativa entre a pontuação na SLEDAI e o escore da EFN. Não foi encontrada, portanto, associação entre alterações da personalidade e atividade do lúpus. De acordo com a EFN, seis pacientes (30 por cento) apresentaram pontuação sugestiva de Transtornos de Personalidade, porém apenas duas (10 por cento) tiveram esse diagnóstico pela avaliação psiquiátrica. Também não foi encontrado um padrão típico de personalidade ou prevalência de um Transtorno de Personalidade específico na amostra; entretanto, houve uma prevalência importante de Depressão (65 por cento). CONCLUSÕES: Verificou-se na população estudada que as pacientes lúpicas podem apresentar os mais variados tipos de comportamento e sintomas psiquiátricos, não havendo nelas um padrão típico de personalidade. Não foi encontrada uma relação significativa entre as alterações de personalidade e atividade da doença.
OBJECTIVE: The objective of the present study was to evaluate personality traits and associated changes in female patients with Systemic Lupus Erythematosus (SLE), linking variations in disease activity with alterations in personality traits. PATIENTS AND METHODS: Twenty patients from the Rheumatology Outpatient Clinic at the University Hospital of Universidade Federal de Mato Grosso do Sul (UFMS) participated in this study. Patients were re-evaluated three and six months after the initial evaluation for the presence of Psychiatric Disorders (especially personality changes) and lupus activity. The Adjustment/Neuroticism Factorial Scale (AFS) and Systemic Lupus Erythematosus Disease Activity Index (SLEDAI), along with clinical psychiatric and rheumatologic assessment, were used to evaluate patients. RESULTS: No significant correlation between SLEDAI and AFS scores was observed. According to the AFS, the scores of six patients (30 percent) were suggestive of Personality Disorders, but psychiatric evaluation confirmed this diagnosis in only two (10 percent) patients. A typical personality pattern or prevalence of a specific Personality Disorder was not observed; however, an important prevalence of Depression (65 percent) was observed. CONCLUSIONS: Our findings showed that patients with lupus can develop different types of behavior and psychiatric symptoms without a typical personality trait. No significant correlation between personality changes and disease activity was observed.