Delusional parasitosis in dementia with Lewy bodies: a case report

Ochiai, Sho; Sugawara, Hiroko; Kajio, Yusuke; Tanaka, Hibiki; Ishikawa, Tomohisa; Fukuhara, Ryuji; Jono, Tadashi; Hashimoto, Mamoru

doi:10.1186/s12991-019-0253-3

Cited by 17 publications

(15 citation statements)

References 22 publications

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“…It is now believed that decreased transporter activity plays a key role in the etiopathogenesis of this disease dopamine in the striatum, which results in an increase in extracellular dopamine concentration [13]. This hypothesis is confirmed by observations of occurrence of delusional parasitosis in patients with neurodegenerative diseases, such as Huntington's chorea, Alzheimer's disease or vascular dementia [14]. Many other disorders have been shown to cause a secondary or organic form of delusional parasitosis, including, but not limited to: schizophrenia, depression, alcoholism, vitamin B 12 and iron deficiency are associated with impaired dopaminergic conduction [6].…”

Section: Discussionmentioning

confidence: 75%

“…Hipotezę tę potwierdzają obserwacje dotyczące występowania obłędu pasożytniczego u pacjentów z chorobami neurodegeneracyjnymi, np. pląsawicą Huntingtona, chorobą Alzheimera i otępieniem naczyniopochodnym [14]. Wykazano, że wiele innych zaburzeń będących przyczyną wtórnej lub organicznej postaci obłędu pasożytniczego, w tym schizofrenia, depresja, alkoholizm, niedobór witaminy B 12 i żelaza, wiąże się z zaburzeniami przewodnictwa dopaminergicznego [6].…”

Section: Discussionunclassified

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Delusional parasitosis (Ekbom syndrome) – a psychodermatologic disorder

Stroynowska-Kosik¹,

Zyzak²,

Biało-Wójcicka³

2021

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Introduction. Delusional parasitosis is a psychotic disorder characterized by an isolated delusional judgment about the presence of parasites moving under or in the skin. Objective. Presentation of a case of delusional parasitosis in a patient treated with psychoactive drugs. Case report. A 73-year-old woman was admitted to the hospital because of extensive erosive skin lesions. Skin lesions with associated itching have been present for about 7 years. The patient associated them with a parasitic infection with nematodes. The patient reported that she was intentionally infected by a person that she met in a public place. Testing for parasitic infestations gave repeatedly negative results. The patient was treated with antiparasitic preparations with no satisfactory improvement. Histology image showed features corresponding to prurigo nodularis. After consultation with a psychiatrist, during the hospital stay, the antipsychotic treatment with olanzapine was started at the dose of 10 mg/day with a good response to treatment. Conclusions. Knowledge of psychodermatological conditions in everyday clinical practice may contribute to the improvement of diagnostics and faster implementation of effective treatment of psychodermatoses. streszczenie Wprowadzenie. Obłęd pasożytniczy jest zaburzeniem psychotycznym, charakteryzującym się pojedynczym sądem urojeniowym co do obecności pasożytów poruszających się pod skórą i/lub w skórze. Cel pracy. Przedstawienie przypadku obłędu pasożytniczego u pacjentki leczonej lekami psychiatrycznymi. Opis przypadku. Kobieta 73-letnia została przyjęta na oddział z powodu rozległych zmian nadżerkowych na skórze. Zmiany skórne ze świądem występowały od około 7 lat. Pacjentka wiązała je z infekcją pasożytniczą nicieniami. Twierdziła, że została celowo zarażona przez osobę przypadkowo spotkaną w miejscu publicznym. W wielokrotnie wykonanych badaniach w kierunku potwierdzenia infekcji pasożytniczej uzyskiwała wyniki ujemne. Leczona preparatami przeciwpasożytniczymi -bez zadowalającej poprawy. W obrazie histologicznym stwierdzono obraz mogący odpowiadać prurigo nodularis. Po konsultacji z lekarzem psychiatrą w trakcie pobytu w szpitalu włączono lecze-

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Section: Discussionmentioning

confidence: 75%

Section: Discussionunclassified

Delusional parasitosis (Ekbom syndrome) – a psychodermatologic disorder

Stroynowska-Kosik¹,

Zyzak²,

Biało-Wójcicka³

2021

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“…Both patients had visual hallucinations, which is one of the core clinical features of DLB. Among four prior cases of delusional infestation diagnosed with DLB, two patients had visual hallucinations (7)(8)(9). Even in cases of suspected dementia in which a diagnosis of DLB had not been made, the coexistence of complex visual hallucinations and delusional infestation have been reported (15)(16)(17).…”

Section: Discussionmentioning

confidence: 99%

“…Psychosis in older people are frequently developed in prodromal stage and early stage of dementia (6). However, there are only a few reports on delusional infestation in DLB (7)(8)(9). Herein, we report our experience with two patients with DLB and delusional infestation who were both safely treated with medication.…”

Section: Introductionmentioning

confidence: 92%

Case report: Delusional infestation in dementia with Lewy bodies

Taomoto

Kanemoto²,

Satake³

et al. 2022

Front. Psychiatry

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BackgroundDelusional infestation is characterized by delusions of being infested with parasites, vermin, or small insects and is frequently accompanied by tactile and visual hallucinations. Herein, we report two cases of dementia with Lewy bodies (DLB) with delusional infestation.Case presentationCase 1 was an 83-year-old man. At the age of 75, he began to show symptoms of rapid eye movement sleep behavior disorder. At the age of 83, he began to complain of visual hallucinations of people and delusional infestation with tactile and visual hallucinations of insects, resulting in the use of insecticides for non-existent insects. He also complained of mild amnesia and was admitted to our psychiatric ward for evaluation and treatment. After admission, the delusional infestation disappeared without any new medication. Based on our examinations, he was diagnosed with probable DLB with delusional infestation. He was treated with 5 mg/day of donepezil hydrochloride; his visual and tactile hallucinations disappeared, and the delusional infestation had not recurred at the 1-year follow-up. Case 2 was a 69-year-old woman. At the age of 60, she underwent clipping for subarachnoid hemorrhage (SAH). At the age of 65, she began to have visual hallucinations of people. At the age of 67, she began to complain of visual illusions in which she mistook lint for insects. At the age of 69, she developed delusional infestation and mild amnesia. She took various actions to get rid of these non-existent insects, including insecticide use, consulting an exterminator, and visiting several dermatologists. She eventually burnt her leg in an attempt to kill the non-existent insects. Based on our examinations, she was diagnosed with prodromal DLB in addition to SAH sequelae. We determined that her delusional infestation was caused by DLB rather than SAH sequelae based on the course of her symptoms. She was treated with a combination of 3 mg/day of donepezil hydrochloride and 12.5 mg/day of quetiapine. Thereafter, the delusional infestation partially improved, and she took no further action against non-existent insects.ConclusionDelusional infestation may be caused by DLB. Acetylcholinesterase inhibitors (AChEI) may be effective for delusional infestation in DLB, although antipsychotics may also be needed in severe cases.

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“…More than 50% of these patients develop delusions in the mild stages (clinical dementia rating, 0.5) ( 20 ). There have been some reports on patients with DLB and unusual delusions, such as Othello syndrome ( 11 ), delusional parasitosis ( 21 , 22 ) and delusion of duplication ( 23 ). In particular, Othello syndrome, characterized by delusional beliefs of infidelity of a partner, was known to be found in as much as 26.3% of DLB ( 11 ).…”

Section: Discussionmentioning

confidence: 99%

Case Report: De Clerambault's Syndrome in Dementia With Lewy Bodies

et al. 2021

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Background: Erotomania, also known as de Clerambault's syndrome, is characterized by the delusion that a person has fallen in love with the patient. It occasionally appears secondary to psychiatric disorders and organic brain diseases. However, there have been no reports on cases secondary to dementia with Lewy bodies (DLB).Case Presentation: The patient was an 83-year-old woman who lived alone. Mild cognitive impairment appeared at the age of 82 years. Soon after, she had the delusional conviction that her family doctor was in love with her. Her symptoms, such as gradually progressive cognitive impairment, cognitive fluctuations, and parkinsonism, indicated DLB. She was treated with a small dose of antipsychotic agents.Conclusions: This case report suggests the possibility of de Clerambault's syndrome during the early stages of DLB. Further investigations are required to clarify the mechanism and treatment of de Clerambault's syndrome in patients with DLB.

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Delusional parasitosis in dementia with Lewy bodies: a case report

Cited by 17 publications

References 22 publications

Delusional parasitosis (Ekbom syndrome) – a psychodermatologic disorder

Delusional parasitosis (Ekbom syndrome) – a psychodermatologic disorder

Case report: Delusional infestation in dementia with Lewy bodies

Case Report: De Clerambault's Syndrome in Dementia With Lewy Bodies

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