A Previously Healthy Adolescent With Acute Psychosis and Severe Hyperhidrosis

A previously healthy 15-year-old boy presented with 3 months of progressive psychosis, insomnia, back and groin pain, and hyperhidrosis. On examination, the patient was disheveled, agitated, and soaked with sweat, with systolic blood pressure in the 160s and heart rate in the 130s. Aside from occasi...

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Bibliographic Details
Published in:Pediatrics (Evanston) 2020-06, Vol.145 (6), p.1
Main Authors: Rosenblatt, Tatiana, Ort, Katherine, Shaw, Richard, Levy, Rebecca J, Chen, Chen, Niemi, Angela, Hoang, Kim
Format: Article
Language:English
Subjects:
Blood pressure
Hallucinations
Heart rate
Hyperhidrosis
Magnetic resonance imaging
Pediatrics
Psychosis
Sensory integration
Sleep disorders
Spine (lumbar)
Teenagers
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Summary:A previously healthy 15-year-old boy presented with 3 months of progressive psychosis, insomnia, back and groin pain, and hyperhidrosis. On examination, the patient was disheveled, agitated, and soaked with sweat, with systolic blood pressure in the 160s and heart rate in the 130s. Aside from occasional auditory and visual hallucinations, his neurologic examination was normal. The patient was admitted for an extensive workup, including MRI of the brain and spine and lumbar puncture, which were normal. Through collaboration with various pediatric specialists, including psychiatry and neurology, a rare diagnosis was ultimately unveiled.
ISSN:0031-4005
1098-4275
DOI:10.1542/peds.2019-3786