A Case of Klinefelter's Syndrome with Schizophrenia-Like Symptoms

A case of Klinefelter's syndrome with schizophrenia-like symptoms is reported. He was given a diagnosis of schizophrenia at the age of 39. After being treated with medication for many years, he stopped taking them at the age of seventy-two and involuntary movements appeared in his limbs and the trunk. Upon admission to our hospital, he was experiencing delusion and psychosocial exitement. A physical examination showed hime to be a thin man of 175.5cm height, suffering from a mild degree of gynecomastia, testicular atrophy. Serum LH and FSH were both high 10.9 and 47.8mU/ml respectively. Serum testosterone concentration was 0.2ng/ml, much lower than the normal range (2.7-10.7ng/ml). On the Wechsler adult intelligence scale (Revision), his total IQ was 103 (performance IQ 100, verbal IQ105). Karyotype analysis revealed an XXY pattern. Although slight auditory hallucinations remained, the delutional symptoms as well as the involuntary movemets diminished after the administration of psychotrophics. Personality changes such as apathy and abulia was subsided. The psychological symptoms were very simillar to these of cases in other reports of Klinefelter's syndrome associated with schizophrenia-like sympotoms. Some reports about the relationships between sex hormones and schizoprenia including other psychotic disorders suggestthat the X-chromosome plays an important part in the mechanism of psychosocial symptoms and in the prognosis in Klinefelter's syndrome.