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Bipolar Disorder and Autoimmune Polyendocrinopathy

Published online by Cambridge University Press:  15 April 2020

M. Bel Feki
Affiliation:
Psychiatry, Razi Hospital, Tunis, Tunisia
S. Derouiche
Affiliation:
Psychiatry, Razi Hospital, Tunis, Tunisia
R. Kammoun
Affiliation:
Psychiatry, Razi Hospital, Tunis, Tunisia
O. Mziou
Affiliation:
Psychiatry, Razi Hospital, Tunis, Tunisia
L. Mnif
Affiliation:
Psychiatry, Razi Hospital, Tunis, Tunisia
W. Melki
Affiliation:
Psychiatry, Razi Hospital, Tunis, Tunisia

Abstract

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Introduction :

Bipolar disorders are frequent troubles touching 1 to 2% of the general population. Their occurrence in a field of autoimmunity evokes common physiopathological mechanisms which are still unknown and a probably underestimated association.

Method

Presentation of a case report.

Case report

This case is about a 32-year-old woman with a history of type 1 diabetes, coeliac disease, and hypothyroidism, followed since the age of 22 for a type 1 bipolar disorder. She was admitted in psychiatric care for psychomotor instability, irritability, logorrhea, aggressiveness, subtotal insomnia, and delirious ideas of greatness, all treatment having been stopped for about twenty days, with besides a diabetic ketoses and non-adherence to a gluten-free diet. We have retained the diagnosis of mania with mood-congruent psychotic features within a type 1 bipolar disorder. Psychiatric treatment was instituted, based on mood stabilizers and atypical antipsychotics, with an equilibration of diabetes, reinstitution of a gluten-free diet, and adjustment of the thyroid hormones therapy. This was followed, within 15 days, by a good stabilization of her condition, both psychiatrically and somatically.

Conclusion

It is well established that psychiatric disorders can exist in some autoimmune diseases. The imputability of the bipolar disorder to the autoimmune polyendocrinopathy remains possible. Further studies are necessary to elucidate the aetiopathological mechanisms.

Type
Article: 1158
Copyright
Copyright © European Psychiatric Association 2015
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