Abstract
We report a case of a 33-year-old man with neurofibromatosis who manifested hyperventilation. He was admitted to a surgical ward of this hospital because of anemia and bleeding of duodenal tumor. On the 4th and 37th hospital days, he was opearted on for duodenal tumor and postoperative ileus. Histologically, the duodenal tumor was benign (leiomyoma). During hospitalization, he was emotionally stable. He was discharged on the 78th hospital day, but a month after discharge, he was readmitted because of shortness of breath, chest pain, numbness of extremities and dizziness. By precise medical examination, he was diagnosed as hyperventilation, and placed under drug therapy. But he was emotionally unstable, and was transferred to our department. In a ward, his pattern of interpersonal relationship looked to be strongly infludnced by inferiority complex derived from neurofibromatosis. Under such conditions, he expressed various worries about neurofibromatosis. He and his family tended to avoid talking about neurofibromatosis each other.He had a history of neurofibromatosis as follows ; He became aware of tumors and pigmented spots when he was around 12 years. A diagnosis of neurofibromatosis was made at age 20. He has not received treatment, however, necause he has been asymptomatic. Only skin sysmptoms of neurofibromaosis were observed. There were Cafe-au-lait spots over the trunk, and multiple skin tumors were present all over the trunk, on the head and neck. No other remarkable symptoms were found. Personal history is described as below. He is the oldest son of 4 brothers and is the only single person in the family. Now he lives with his parents and the toungest brother and his wife who got married three month ago. He has been working at a confectionery after he graduated from senior high school. There was no history of neurofibromatosis in the family.Our discussion included the following points : (1) It was considered that the patient's anxiety about neurofibromatosis was an important factor which produced hyperventilation.(2) Family relationship centerng around neurpfibromatosis infulenced the progress toward recovery.(3)Finally we emphasized the need to treat emotional pains of the patients with neurofibromatosis and their family.
