PT  - JOURNAL ARTICLE
AU  - Simon S Rabinowitz
AU  - Neha Ahuja
AU  - Jennifer Gottfried
TI  - Aripiprazole reversed gastroparesis in a child with 1q21.1–q21.2 microdeletion
AID  - 10.1136/bcr-2017-223231
DP  - 2018 Mar 15
TA  - BMJ Case Reports
PG  - bcr-2017-223231
VI  - 2018
4099  - http://casereports.bmj.com/content/2018/bcr-2017-223231.short
4100  - http://casereports.bmj.com/content/2018/bcr-2017-223231.full
AB  - An 11-year-old Caucasian boy, with a microdeletion in the 1q21.1–q21.2 region, had multiple medical conditions including gastroparesis documented initially at the age of 5. The patient had a history of poor feeding since infancy and had been treated for gastro-oesophageal reflux disease (GERD), constipation and multiple food allergies. As a consequence of the GERD and his concurrent immunoglobulin (IgG) subclass deficiency, the patient had multiple otolaryngologic (ENT) infections and required two sinus surgeries. The patient had poor weight gain (below the third percentile for weight-for-age) and required a short course of parenteral nutrition and eventually a gastrostomy tube. He was started on metoclopramide as treatment for gastroparesis with an increase in his appetite, oral intake and weight gain. However, severe headaches and worsening in his behaviour caused the agent to be discontinued. He had little weight gain and after a course of parenteral nutrition he was converted to a transpyloric feeding tube. Because of ongoing behavioural problems that interfered with his school performance, a psychiatrist started him on aripiprazole. After aripiprazole was prescribed at age 11, his appetite and oral intake dramatically increased and a repeat gastric emptying study was normal. The increased oral intake and weight gain continued, allowing removal of the feeding tube. More than 2 years later, on aripiprazole, he continues to gain weight without any supplemental feedings.