An adolescent girl with hypertension and neuropsychiatric symptoms: Questions

Excerpt

An 11-year-old girl was admitted to our hospital with complaints of weakness, weight loss (10 kg in the last month), excessive sweating, and abdominal and joint pains. Her complaints started 6 weeks prior to admittance when she began to suffer from intermittent fever and back and abdominal pain. Four weeks before admission to our center, she presented to a local hospital with dysuria, itching, and a burning sensation in the genital region; she was diagnosed with a urinary tract infection (UTI) and treated with antibiotics. During this period of time, her abdominal pain and myalgia persisted. On further evaluation, Rose Bengal, Brucella, and Salmonella agglutination tests yielded negative results, and abdominal ultrasonography (USG) results were normal. During hospitalization, behavioral changes were noted including insomnia, irritability, delirium, hallucinations, and tremors, and she was referred to our hospital’s psychiatry department. Before an extensive psychiatric evaluation, she underwent clinical testing at our center in order to rule out organic pathologies. Her past and family histories were unremarkable. …