Kaşeksi Düzeyinde Şiddetli Kilo Kaybıyla Ortaya Çıkan Somatik Semptom Bozukluğu: İlginç ve Nadir Bir Olgu Sunumu

Öz

42 yaşında bir erkek hasta, dayısının aynı hastalıktan ölmesinin ardından mide kanseri olduğuna dair kalıcı bir inanç geliştirdi. Başlangıçta hastalık anksiyetesi bozukluğu (HAD) teşhisi kondu; ancak normal endoskopik bulgulara rağmen ilerleyici iştahsızlık ve belirgin kilo kaybı nedeniyle tanısı daha sonra somatik semptom bozukluğu (SSB) olarak değiştirildi. İki yıllık takip süresi boyunca uygulanan kapsamlı psikiyatrik ve tıbbi tedaviler yalnızca minimal iyileşme sağladı. Hasta sonunda pnömoni nedeniyle hastaneye kaldırıldı ve sepsis nedeniyle hayatını kaybetti. Son yatışı sırasında alınan mide biyopsisi ile tesadüfen erken evre adenokarsinom teşhis edildi. Bu vaka, şiddetli psikojenik kilo kaybı ile karakterize nadir bir SSB tablosunu göstermekte ve olumsuz tıbbi sonuçları önlemek için atipik ve tedaviye dirençli vakalarda erken multidisipliner tedavinin önemini vurgulamaktadır.

Anahtar Kelimeler

• Somatoform Bozukluklar
• Hipokondriyazis
• Ağırlık kaybı
• Kaşeksi
• Mide Neoplazmları

Somatic Symptom Disorder Presenting with Severe, Cachexia-Level Weight Loss: An Interesting and Rare Case Report

Öz

A 42-year-old man developed a persistent belief that he had gastric cancer following his maternal uncle’s death from the same disease. He was initially diagnosed with illness anxiety disorder (IAD); however, due to progressive loss of appetite and marked weight reduction despite normal endoscopic findings, his diagnosis was later revised to somatic symptom disorder (SSD). Over a two-year follow-up period, extensive psychiatric and medical treatments yielded only minimal improvement. The patient was eventually hospitalized with pneumonia and died from sepsis. A gastric biopsy obtained during his final admission incidentally revealed early-stage adenocarcinoma. This case illustrates a rare presentation of SSD characterized by severe psychogenic weight loss and highlights the importance of early multidisciplinary management in atypical and treatment-resistant cases to prevent adverse medical outcomes.

Anahtar Kelimeler

• Somatoform Disorders
• Hypochondriasis
• Weight Loss
• Cachexia
• Gastric Neoplasms

Kaynakça

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