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Dr. Andrew Rynne
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Dr. Andrew Rynne

Family Physician

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Child Suffering With AIP, Gets Some Foul Smell From Somewhere In The House. Psychiatric Or Something Else?

Hi my 13 old daughter is an AIP patient. recently she had an attack of AIP and is just released from hospital. She has started complaining of severe pain in her left side of chest due to which she gets stiffened for some time like 5-10 minutes and after that she is relaxed we told the doctors they checked her all vitals and found them normal ECG BP Heart rate etc. all were checked during such thing and before after such things but nothing was wrong. they have told us that it is due to psychiatric menifestations recently she is getting some foul smell from somewhere in home how to get her out of such things and how to know whether it is psychiatric or something else.
Thu, 4 Jul 2013
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Psychiatrist 's  Response
Hi,

13 year old known case of AIP with recent onset of foul smell (olfactory hallucinations) and stiffening (?catatonia).

AIP is a genetic disorder that can present with varied psychiatric symptoms. In these patients, the psychiatric symptoms (like hallucinations and catatonia) are usually seen along with the acute attacks, while in between attacks patients are normal and free of any psychiatric manifestations. Since you have seen her previous attacks, try to establish a relationship between the psychiatric symptoms and acute attacks. There can also be a chronic form of disorder where there is a background of few symptoms on top of which acute attacks occur intermittently. So in these cases it can be difficult to differentiate.

Either ways, the treatment for this symptom would be the same (apart from treatment and prevention of attacks). Many drugs are unsafe to give in these patients, Phenothiazine groups of drugs are known to be safe in them.

Discuss this with an experienced paediatrician. He will be able to guide you.

Hope this helps,
Dr A Rao
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Psychiatrist Dr. Sushil Kumar Sompur's  Response
Hi there ~

I understand your concerns. AIP or acute intermittent porphyria is commonly associated with visual, auditory, gustatory and olfactory hallucinations. I do not think it is psychiatric in origin. However psychiatric problems are also common in such children. I advise you to consult a good pediatrician who is expert in genetics so as to get the right cure for your child'd condition.

I hope this helps. Take good care of yourself and have a lovely day!
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Child Suffering With AIP, Gets Some Foul Smell From Somewhere In The House. Psychiatric Or Something Else?

Hi, 13 year old known case of AIP with recent onset of foul smell (olfactory hallucinations) and stiffening (?catatonia). AIP is a genetic disorder that can present with varied psychiatric symptoms. In these patients, the psychiatric symptoms (like hallucinations and catatonia) are usually seen along with the acute attacks, while in between attacks patients are normal and free of any psychiatric manifestations. Since you have seen her previous attacks, try to establish a relationship between the psychiatric symptoms and acute attacks. There can also be a chronic form of disorder where there is a background of few symptoms on top of which acute attacks occur intermittently. So in these cases it can be difficult to differentiate. Either ways, the treatment for this symptom would be the same (apart from treatment and prevention of attacks). Many drugs are unsafe to give in these patients, Phenothiazine groups of drugs are known to be safe in them. Discuss this with an experienced paediatrician. He will be able to guide you. Hope this helps, Dr A Rao