治療終了後に精神症状を認めた小児癌症例

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  • Survivors of Childhood Cancer with Symptoms of Mental Disorders.

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We here present four patients with mental problems as late effects of pediatric malignant disease and discuss these patients in terms of post-traumatic stress disorder (PTSD). Patient 1 : Wilms' tumor developed in a 9-year-old, patient had three operations and prolonged chemotherapy with severe vomiting during CDDP administration. Any slight difficulty in his life caused severe vomiting and finally, the patient died of a severe electrolyte imbalance due to frequent vomiting. Somatoform autonomic dysfunction due to PTSD was diagnosed. Patient 2 : Acute lymphocytic leukemia developed in a 12-year-old ; however, anxiety, rough language and violence were observed. Therapy was changed to an outpatient administration. The protocol was successfully completed, but many problems developed due to a generalized anxiety disorder. PTSD accompanied with personality disorder was diagnosed. Patient 3 : Non-Hodgkin lymphoma developed in a 5-year-old. After the end of therapy, she frequently complained of low-grade fever, headache, and abdominal pain. At high school, she often complained about her teacher and her mother and showed symptoms of hyperventilation, hysteria and syncope. Conversion disorder and personality disorder were diagnosed but PTSD was not. Patient 4 : At nine years old, the patient developed acute myelocytic leukemia. At 11 years old, he complained of low-grade fever, chest pain and headache and a twilight state at 14 years old. He could enter a vocational college but soon left the college since the symptoms became more severe. Dissociative disorders accompanying PTSD were diagnosed.

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