Abstract
Altı yaşında sağlıklı ikiz eşi olan erkek hasta öksürük, balgam ve mide bulantısı şikayetleriyle aile hekimliği polikliniğimize başvurdu. Fizik muayenede ateş 36,7°C, orofarinks hiperemik, tonsiller hipertrofikti, sol kulakta akıntı mevcuttu, akciğer sesleri doğaldı. Hastaya “Akut Üst Solunum Yolu Enfeksiyonu” tanısı koyularak tedavi başlandı. Muayene süresince hasta ajite ve korkuluydu, dikkatini toplayamıyor, göz teması kurmuyor, sorulara ve uyarılara yanıt vermiyor, bağırma ve ağlamayla birlikte saldırgan özellikler gibi ikizinden belirgin davranışsal farklılıklar sergiliyordu. Özgeçmişi sorgulandığında 45 yaşındaki baba ve 35 yaşındaki anneden in vitro fertilizasyon yöntemiyle 35 hafta 4 günlük 2650 gr doğduğu, 8 ay anne sütü aldığı, 2 yaş civarında tek kelime konuşabildiği, genel olarak nörogelişimsel sürecin ikizinden daha geride olduğu ortaya çıkmıştır. Bu durum dikkate alınarak otizm şüphesi üzerine hasta çocuk psikiyatri polikliniğine yönlendirildi. Yapılan inceleme sonucu üç yıl önce hastamızın konuşmasının ikiziyle aynı dönemde başlamaması üzerine hastamız ilk defa çocuk psikiyatri polikliniğinde değerlendirilmiş, otizm ön tanısıyla 3 ay sonra kontrole gelmesi önerilmiş. Önerilen kontrole gelmeyen hasta aile hekimliği polikliniğimizdeki değerlendirme sonucu yönlendirilmesiyle “Otizm” tanısı aldı.
Keywords
References
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- 5. World Health Organisation. WHO remains firmly committed to the principles set out in the preamble to the Constitution. https://www.who.int/about/who-we-are/constitution. Accessed Jan 1, 2021.
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Abstract
A six-year-old male patient who has a twin healthy brother was admitted to our family medicine clinic with complaints of cough, sputum, and nausea. On physical examination, fever was 36.7°C, oropharynx was hyperemic, he had tonsillar hypertrophy, left ear discharge and respiratory sounds were natural. The patient was diagnosed with "Acute Upper Respiratory Tract Infection" and treatment was started. During the examination, the patient was agitated and fearful, unable to concentrate, did not make eye contact, did not respond to questions and warnings, and exhibited distinct behavioral differences from his twin, such as shouting and crying, and aggressive features. When his medical history was questioned, he was learned to have born to a 45-year-old father and a 35-year-old mother through in vitro fertilization method on 35 weeks and 4 days, he was 2650 gram. He was breastfed for 8 months, could speak a word around the age of 2, and there was usually a neurodevelopmental process behind his twin. Considering this situation, the patient was referred to the child psychiatry outpatient clinic due to the suspicion of autism. He was evaluated in the child psychiatry outpatient clinic for the first time three years ago, since his speech did not start at the same time with his twin, and he was recommended to come for a follow-up visit 3 months later with a pre-diagnosis of autism. The patient, who did not come for the control, was diagnosed with "Autism" after the evaluation in our family medicine clinic.
References
- 1. Tanıdır C, Mukaddes NM, Otizm Spektrum Bozuklukları. In: Pekcanlar Akay A, Ercan ES, editors. Çocuk ve Ergen Ruh Sağlığı ve Hastalıkları. Ankara: Türkiye Çocuk ve Genç Psikiyatrisi Derneği Yayınları;2016. p. 126-49.
- 2. Mukaddes NM, Tanıdır C. Otizm Spektrum Bozukluklarında Psikiyatrik Komorbidite. Turkiye Klinikleri J Child Psychiatry-Special Topics 2015;1(2):30-42.
- 3. Matson JL. Determining treatment outcome in early intervention programs for autism spectrum disorders: A critical analysis of measurement issues in learning based interventions. Research in developmental disabilities 2007; 28(2): p. 207- 218.
- 4. Reichow B, Baron EE, Boyd BA, Hume K. Early intensive behavioral intervention for young children with autism spectrum disorders. In: Cochrane Databse of Systematic Reviews [Internet]. Accessed Jan 1, 2021. http://www.ncbi.nlm.nih.gov/pubmed/23076956 doi: 10.1002/14651858.CD009260.pub2.
- 5. World Health Organisation. WHO remains firmly committed to the principles set out in the preamble to the Constitution. https://www.who.int/about/who-we-are/constitution. Accessed Jan 1, 2021.
- 6. Ford S. Patient‐centered Medicine, Transforming the Clinical Method (2nd edition). Health Expect. 2004;7(2):181-182. doi:10.1111/j.1369-7625.2004.00270.x.
- 7. Yarış F. Koruyucu Hekimlikte Klinik Yöntem. Turkiye Klinikleri J Fam Med-Special Topics 2013;4(5):24-8.
Details
| Primary Language | English |
|---|---|
| Subjects | Internal Diseases |
| Journal Section | Case Report |
| Authors | |
| Publication Date | September 10, 2021 |
| Submission Date | January 6, 2021 |
| Published in Issue | Year 2021 Volume: 15 Issue: 3 |
English or Turkish manuscripts from authors with new knowledge to contribute to understanding and improving health and primary care are welcome.