29歳で発症した前頭型Pick病の臨床例

A Clinical Case of Sporadic Frontal Pick's Disease with Onset at 29-year-old of Age

【抄録】　若年発症の前頭型Pick病の臨床例を報告した。症例は初診時33歳の男性で，精神疾患および神経変性疾患の家族歴はない。29歳時に人格変化で発症し自発性低下などの症状が緩徐に進行した。臨床症状に加えて，33歳時に施行した頭部CTで，前頭葉にほぼ限局した萎縮とその後約1年間での萎縮の進行を確認して前頭型Pick病と臨床診断した。20歳代で発病したPick病の症例は極めて稀で，海外で8例が報告されているにすぎず，本邦では本症例が最初の報告例である。また，前頭型という病変分布も本邦では比較的稀である。本症例は，成人早期の精神疾患の鑑別として，稀ではあるが，Pick病も考慮すべき疾患であるという観点からも重要な症例と考える。

　A 29-year-old male patient presented with personality change without any family history of dementia or other psychiatric disorder. At the age of 33 years, he was diagnosed as having Pick's disease. based on his clinical symptoms and head CT findings. Clinical symptoms were also consistent with clinical criteria for frontotemporal dementia. Head CT showed progressive atrophy of the bilateral frontal lobes and temporal tips. The predominant symptoms including initiative loss, were due to degeneration of the orbital-frontal regions.

　Young-onset-cases of Pick's disease have rarely been reported. In addition, no case with such a young onset as our case has been reported in Japan. Pick's disease should thus be considered for the differential diagnosis of behavioral and cognitive decline in young adults.