A case of autophagia: a man who was mutilating his fingers by biting them - PubMed

Case Reports

A case of autophagia: a man who was mutilating his fingers by biting them

Ioannis Michopoulos et al. J Nerv Ment Dis. 2012 Feb.

Abstract

Self-mutilating behaviors could be minor and benign, but more severe cases are usually associated with psychiatric disorders or with acquired nervous system lesions and could be life-threatening. The patient was a 66-year-old man who had been mutilating his fingers for 6 years. This behavior started as serious nail biting and continued as severe finger mutilation (by biting), resulting in loss of the terminal phalanges of all fingers in both hands. On admission, he complained only about insomnia. The electromyography showed severe peripheral nerve damage in both hands and feet caused by severe diabetic neuropathy. Cognitive decline was not established (Mini Mental State Examination score, 28), although the computed tomographic scan revealed serious brain atrophy. He was given a diagnosis of impulse control disorder not otherwise specified. His impulsive biting improved markedly when low doses of haloperidol (1.5 mg/day) were added to fluoxetine (80 mg/day). In our patient's case, self-mutilating behavior was associated with severe diabetic neuropathy, impulsivity, and social isolation. The administration of a combination of an antipsychotic and an antidepressant proved to be beneficial.

Similar articles

• [Electroconvulsive therapy for multiple major self-mutilations in bipolar psychotic depression].

  Arora M, Praharaj SK, Prakash R. Arora M, et al. Turk Psikiyatri Derg. 2008 Summer;19(2):209-12. Turk Psikiyatri Derg. 2008. PMID: 18561053 Turkish.

• [A 76-year-old man with loss of vision and dementia].

  Miyashita N, Imai H, Mori H, Kodera M, Shirai T, Mizuno Y. Miyashita N, et al. No To Shinkei. 1997 Aug;49(8):773-82. No To Shinkei. 1997. PMID: 9282374 Japanese.

• The significance of aggression and impulsivity for self-mutilative behavior.

  Herpertz S, Steinmeyer SM, Marx D, Oidtmann A, Sass H. Herpertz S, et al. Pharmacopsychiatry. 1995 Oct;28 Suppl 2:64-72. doi: 10.1055/s-2007-979622. Pharmacopsychiatry. 1995. PMID: 8614703 Clinical Trial.

• Using antipsychotic agents in older patients.

  Alexopoulos GS, Streim J, Carpenter D, Docherty JP; Expert Consensus Panel for Using Antipsychotic Drugs in Older Patients. Alexopoulos GS, et al. J Clin Psychiatry. 2004;65 Suppl 2:5-99; discussion 100-102; quiz 103-4. J Clin Psychiatry. 2004. PMID: 14994733 Review.

• [A case of complete self-mutilation of penis].

  Tomita M, Maeda S, Kimura T, Ikemoto I, Oishi Y. Tomita M, et al. Hinyokika Kiyo. 2002 Apr;48(4):247-9. Hinyokika Kiyo. 2002. PMID: 12048941 Review. Japanese.

Cited by

• Polymicrobial pyogenic flexor tenosynovitis of the index finger and first ray resulting from autophagia.

  Harris AP, Johnson J, Kluk A, Li NY, Goodman AD, Akelman E. Harris AP, et al. J Orthop. 2017 Jun 30;14(3):403-405. doi: 10.1016/j.jor.2017.06.014. eCollection 2017 Sep. J Orthop. 2017. PMID: 28725123 Free PMC article.

• Self-mutilating autocannibalistic onycophagia causing infectious compartment syndrome, osteomyelitis, and sepsis: A case report and review of the literature.

  Akhavan AA, Catterall LC, Deune EG. Akhavan AA, et al. J Hand Microsurg. 2024 Mar 29;16(4):100064. doi: 10.1016/j.jham.2024.100064. eCollection 2024 Oct. J Hand Microsurg. 2024. PMID: 39234372

• Self-cannibalism: the man who eats himself.

  Yilmaz A, Uyanik E, Balci Şengül MC, Yaylaci S, Karcioglu O, Serinken M. Yilmaz A, et al. West J Emerg Med. 2014 Sep;15(6):701-2. doi: 10.5811/westjem.2014.6.22705. West J Emerg Med. 2014. PMID: 25247046 Free PMC article.

• Self-mutilation of the Fifth Finger in an Infant due to Iatrogenic Ulnar Nerve Neurapraxia: A Clinical Case Report and Review of the Literature.

  Singer M, Schorr L. Singer M, et al. J Am Acad Orthop Surg Glob Res Rev. 2019 Aug 2;3(8):e012. doi: 10.5435/JAAOSGlobal-D-19-00012. eCollection 2019 Aug. J Am Acad Orthop Surg Glob Res Rev. 2019. PMID: 31592505 Free PMC article.

• Is hyperinsulinemia a possible clinical explanation underlying the myth of Erysichthon?

  Saniotis A. Saniotis A. Acta Diabetol. 2023 Sep;60(9):1279-1282. doi: 10.1007/s00592-023-02108-w. Epub 2023 Jun 12. Acta Diabetol. 2023. PMID: 37306712

Publication types

MeSH terms

LinkOut - more resources

• Full Text Sources

  • Ovid Technologies, Inc.
  • Wolters Kluwer