Psychiatry and Clinical Psychopharmacology

Co-existence of Attention deficit hyperactivity disorder and Rathke cleft cyst: a case report

Psychiatry and Clinical Psychopharmacology 2014; 24: Supplement S290-S290
Read: 1266 Published: 17 February 2021

Rathke Cleft Cyst (RCC) is remnant of Rathke pouch, which is formed by invaginations stomodaeum in 3rd or 4th week of gestational life. It is a benign tumor of the pituitary gland. Generally, asymptomatic, symptomatic cysts are quite rare. Although defined as a developmental cyst, it is more common in adults than children, and two times more common in females. To our research, this is the first case of coexistence of Attention deficit hyperactivity disorder (ADHD) and RCC. On the other hand, this case is the second youngest male patient who is diagnosed with RCC in the literature; first one is 4.5 year-old. A 7-year-old-boy was brought to the Child and Adolescent Psychiatry Clinic with forgetfulness and hyperactivity. His development was delayed in reference to his peers (Delayed speech and walking). In the family history; his sister has Panic Disorder, and his uncle has mental retardation. Although he has attended to first grade class for nearly seven months, he could not learn to read and many complaints such as excessive speech at lessons, distractibility in homework, came from the teachers in this period. He is going to go to the repeat first class next year. He was diagnosed with ADHD and Mental Retardation. Magnetic resonance imaging (MRI) has been asked because of the child’s atypical facial appearance, mental retardation and growth retardation. Rathke cyst (1.2x1.8x1.7 cm) was incidentally detected on brain MRI in the process of treatment and follow-up. Performed on blood tests FSH: 0.71 mIU/ml (0.95-11.95) LH: 0.03 mIU/ml (1.14-8.75) testosterone: 0.04 ng/ml (1.42-9.23), results of thyroid function tests, prolactin and cortisol levels were in the normal range. The patient was consulted to endocrinology and neurosurgery departments. We learned that transfenoidal surgery is planned. This is the first case presented in the literature about the coexistence of ADHD and RCC. RCC is rare in pediatric population. Headache, endocrine abnormality and visual loss are the major features of RCC. Our patient was asymptomatic; the cyst was recognized by chance. If there is no other condition with hypogonadotropic hypogonadism, people usually do not consult with a doctor in prepubertal period. Unless treatments are properly managed in adolescents and teenagers, some permanent health problems may be seen in following years. Thus, early diagnosis is important for children. In our clinic, we investigate thyroid hormones, hemogram, iron parameters etc. to diagnose diseases such as ADHD symptoms hyperthyroidism, hypothyroidism and iron deficiency anemia. If we had wanted endocrinological blood tests, we could have had a chance to capture pituitary lesions. If not in all cases, sometimes it may be useful to make MRI and detailed blood test patients who is with mental retardation, growth retardation, atypical facial appearance, considered a syndrome.

EISSN 2475-0581