Periodic Catatonia Marked by Hypercortisolemia and Exacerbated by the Menses: A Case Report and Literature Review
Kahlbaum first described catatonia; later Kraepelin, Gjessing, and Leonhard each defined periodic catatonia differently. A 48-year-old female with catatonia, whose grandmother probably died from it, was prospectively followed for >4 years in a US psychiatric state hospital. Through 4 catatonic ep...
Saved in:
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2018-01-01
|
| Series: | Case Reports in Psychiatry |
| Online Access: | http://dx.doi.org/10.1155/2018/4264763 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832563300871700480 |
|---|---|
| author | Samantha Zwiebel Alejandro G. Villasante-Tejanos Jose de Leon |
| author_facet | Samantha Zwiebel Alejandro G. Villasante-Tejanos Jose de Leon |
| author_sort | Samantha Zwiebel |
| collection | DOAJ |
| description | Kahlbaum first described catatonia; later Kraepelin, Gjessing, and Leonhard each defined periodic catatonia differently. A 48-year-old female with catatonia, whose grandmother probably died from it, was prospectively followed for >4 years in a US psychiatric state hospital. Through 4 catatonic episodes (one lasting 17 months) there were menstrual exacerbations of catatonia and increases in 4 biological variables: (1) creatine kinase (CK) up to 4,920 U/L, (2) lactate dehydrogenase (LDH) up to 424 U/L, (3) late afternoon cortisol levels up to 28.0 mcg/dL, and (4) white blood cell (WBC) counts up to 24,200/mm3 with neutrophilia without infections. Records from 17 prior admissions documented elevations of WBC and LDH and included an abnormal dexamethasone suppression test (DST) which normalized with electroconvulsive therapy. Two later admissions showed CK and WBC elevations. We propose that these abnormalities reflect different aspects of catatonic biology: (1) the serum CK, the severity of muscle damage probably exacerbated by the menses; (2) the hypercortisolemia, the associated fear; (3) the leukocytosis with neutrophilia, the hypercortisolemia; and (4) the LDH elevations, which appear to be influenced by other biological abnormalities. Twentieth-century literature was reviewed for (1) menstrual exacerbations of catatonia, (2) biological abnormalities related to periodic catatonia, and (3) familial periodic catatonia. |
| format | Article |
| id | doaj-art-888a6f69106d4268b99616fb12125458 |
| institution | Kabale University |
| issn | 2090-682X 2090-6838 |
| language | English |
| publishDate | 2018-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Psychiatry |
| spelling | doaj-art-888a6f69106d4268b99616fb121254582025-02-03T01:20:29ZengWileyCase Reports in Psychiatry2090-682X2090-68382018-01-01201810.1155/2018/42647634264763Periodic Catatonia Marked by Hypercortisolemia and Exacerbated by the Menses: A Case Report and Literature ReviewSamantha Zwiebel0Alejandro G. Villasante-Tejanos1Jose de Leon2College of Medicine, University of Kentucky, Lexington, KY 40506, USADepartment of Statistics, University of Kentucky, Lexington, KY 40536, USACollege of Medicine, University of Kentucky, Lexington, KY 40506, USAKahlbaum first described catatonia; later Kraepelin, Gjessing, and Leonhard each defined periodic catatonia differently. A 48-year-old female with catatonia, whose grandmother probably died from it, was prospectively followed for >4 years in a US psychiatric state hospital. Through 4 catatonic episodes (one lasting 17 months) there were menstrual exacerbations of catatonia and increases in 4 biological variables: (1) creatine kinase (CK) up to 4,920 U/L, (2) lactate dehydrogenase (LDH) up to 424 U/L, (3) late afternoon cortisol levels up to 28.0 mcg/dL, and (4) white blood cell (WBC) counts up to 24,200/mm3 with neutrophilia without infections. Records from 17 prior admissions documented elevations of WBC and LDH and included an abnormal dexamethasone suppression test (DST) which normalized with electroconvulsive therapy. Two later admissions showed CK and WBC elevations. We propose that these abnormalities reflect different aspects of catatonic biology: (1) the serum CK, the severity of muscle damage probably exacerbated by the menses; (2) the hypercortisolemia, the associated fear; (3) the leukocytosis with neutrophilia, the hypercortisolemia; and (4) the LDH elevations, which appear to be influenced by other biological abnormalities. Twentieth-century literature was reviewed for (1) menstrual exacerbations of catatonia, (2) biological abnormalities related to periodic catatonia, and (3) familial periodic catatonia.http://dx.doi.org/10.1155/2018/4264763 |
| spellingShingle | Samantha Zwiebel Alejandro G. Villasante-Tejanos Jose de Leon Periodic Catatonia Marked by Hypercortisolemia and Exacerbated by the Menses: A Case Report and Literature Review Case Reports in Psychiatry |
| title | Periodic Catatonia Marked by Hypercortisolemia and Exacerbated by the Menses: A Case Report and Literature Review |
| title_full | Periodic Catatonia Marked by Hypercortisolemia and Exacerbated by the Menses: A Case Report and Literature Review |
| title_fullStr | Periodic Catatonia Marked by Hypercortisolemia and Exacerbated by the Menses: A Case Report and Literature Review |
| title_full_unstemmed | Periodic Catatonia Marked by Hypercortisolemia and Exacerbated by the Menses: A Case Report and Literature Review |
| title_short | Periodic Catatonia Marked by Hypercortisolemia and Exacerbated by the Menses: A Case Report and Literature Review |
| title_sort | periodic catatonia marked by hypercortisolemia and exacerbated by the menses a case report and literature review |
| url | http://dx.doi.org/10.1155/2018/4264763 |
| work_keys_str_mv | AT samanthazwiebel periodiccatatoniamarkedbyhypercortisolemiaandexacerbatedbythemensesacasereportandliteraturereview AT alejandrogvillasantetejanos periodiccatatoniamarkedbyhypercortisolemiaandexacerbatedbythemensesacasereportandliteraturereview AT josedeleon periodiccatatoniamarkedbyhypercortisolemiaandexacerbatedbythemensesacasereportandliteraturereview |