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Vitamin A, C, D, E and B12 levels in leprosy: A case control study
Abstracts / Journal of the Neurological Sciences 405S (2019) 116542
promising treatment option with better clinical outcome even in nonthymomatous myasthenia gravis group. Despite the complete remission condition after thymectomy, patients are still at risk of relapse events, in which several drugs, including types of antibiotics have been associated with its induction or exacerbation. Objective To present a case of successfully treated antibiotics associated relapse in post-thymectomy nonthymomatous Myasthenia Gravis patient who previously has achieved complete remission. Case A 15-year-old male presented with complaints of progressive double vision, bilateral ptosis, and fluctuating general weakness. No thymoma or other mediastinal mass were found on chest CT scan. His symptoms showed only slight improvement and his condition deteriorate despite treatment given. He then underwent plasma exchange and total thymectomy in which he achieved complete remission for four years. He returned with his original complaints after taking cefixime and clindamycin. Results Our examinations yield no possible other causes that may become his relapse trigger. He was then stopped from his antibiotics and treated with pyridostigmine 120 mg daily for two consecutive months and once again achieved complete remission without further medication. Conclusions Medication in patient with Myasthenia Gravis should be carefully considered even in patients who have achieved complete remission as induction and exacerbation may still be possible.
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and B12 levels were measured by enzyme-linked immunosorbent assay. Results Out of 60, 55% patients had paucibacillary leprosy whereas 45% had multibacillary. Mononeuritis multiplex was the commonest electrophysiological finding. The levels of vitamin A, C, D, E and B12 were significantly lower in leprosy cases as compared to healthy controls (Pb0.05). Multibacillary cases showed significantly lower levels of all the vitamins as compared to paucibacillary cases (Pb0.05). Lepromatous leprosy cases showed lowest vitamin levels. Conclusion Vitamin levels in leprosy is lower indicating nutritional deficiencies. This deficient state may be an important risk factor for leprosy susceptibility. Keywords: Leprosy, Vitamin, Neuropathy, Mycobacterium leprae doi:10.1016/j.jns.2019.10.1264
WCN19-0998 Journal of the Neurological Sciences 405S (2019) 104927 Poster Session 3 Unihemispheric demyelination-A rare variant of acute disseminated encephalomyelitis
doi:10.1016/j.jns.2019.10.1263 S.C.J. Chandran Kerala Institute of Medical Sciences, Neurology, Thiruvananthapuram, India
WCN19-0993 Journal of the Neurological Sciences 405S (2019) 104926 Poster Session 3 Vitamin A, C, D, E and B12 levels in leprosy: A case control study N. Kumara, H.S. Malhotraa, V. Garga, R.K. Garga, K.P. Malhotrab a King George's Medical University, Neurology, Lucknow, India b Dr. Ram Manohar Lohia Institute Of Medical Sciences, Pathology, Lucknow, India
Background Vitamins are essential part of nutrition and well-being. Many reports indicate that vitamins may influence the etio-pathogenesis of leprosy. Aims We aimed to compare blood vitamin (A, C, D, E and B12) levels in recently diagnosed leprosy patients with healthy controls. Methods We enrolled 60 newly- diagnosed patients of leprosy. We also included age and sex matched control subjects. All patients were categorized according to World Health Organization classification and the Ridley Jopling classification of leprosy. Vitamins A, C, D, E
ADEM is a monophonic inflammatory demyelination of the central nervous system, characterized by scattered focal or multifocal (disseminated) inflammation of the brain and/or spinal cord. We describe three cases of unihemispheric involvement in ADEM. Case 1 A 30-year-old male presented with acute vomiting, right gaze palsy, right LMN facial palsy, and right cerebellar signs. MRI brain showed T2, FLAIR hyperintense lesions involving right half of brainstem, right cerebellum, and posterior limb of the right internal capsule. CSF study was normal. He improved with steroids. Case 2 An 8- year - old boy presented with left focal to secondary generalized seizures and left hemiplegia. He was in coma. MRI Brain showed T2, FLAIR hyperintense lesions involving right half of brainstem, right cerebellum, thalamus, basal ganglia, right cortical gray matter and subcortical white matter. CSF showed elevated protein without pleocytosis. He was intubated and was given pulse methylprednisolone anti edema measures and levitiracetam. He worsened and expired. Case 3 A 30 year old man presented with right focal seizures and right hemiparesis. MRI Brain showed T2 FLAIR hyper intensities involving left frontal temporal and parietal subcortical white matter and left basal ganglia with micro hemorrhages. CSF study was normal. He improved with steroids. Unilateral involvement is rare in ADEM. Relevant literature and differentiation from other unilateral inflammatory diseases will be discussed. doi:10.1016/j.jns.2019.10.1265
promising treatment option with better clinical outcome even in nonthymomatous myasthenia gravis group. Despite the complete remission condition after thymectomy, patients are still at risk of relapse events, in which several drugs, including types of antibiotics have been associated with its induction or exacerbation. Objective To present a case of successfully treated antibiotics associated relapse in post-thymectomy nonthymomatous Myasthenia Gravis patient who previously has achieved complete remission. Case A 15-year-old male presented with complaints of progressive double vision, bilateral ptosis, and fluctuating general weakness. No thymoma or other mediastinal mass were found on chest CT scan. His symptoms showed only slight improvement and his condition deteriorate despite treatment given. He then underwent plasma exchange and total thymectomy in which he achieved complete remission for four years. He returned with his original complaints after taking cefixime and clindamycin. Results Our examinations yield no possible other causes that may become his relapse trigger. He was then stopped from his antibiotics and treated with pyridostigmine 120 mg daily for two consecutive months and once again achieved complete remission without further medication. Conclusions Medication in patient with Myasthenia Gravis should be carefully considered even in patients who have achieved complete remission as induction and exacerbation may still be possible.
245
and B12 levels were measured by enzyme-linked immunosorbent assay. Results Out of 60, 55% patients had paucibacillary leprosy whereas 45% had multibacillary. Mononeuritis multiplex was the commonest electrophysiological finding. The levels of vitamin A, C, D, E and B12 were significantly lower in leprosy cases as compared to healthy controls (Pb0.05). Multibacillary cases showed significantly lower levels of all the vitamins as compared to paucibacillary cases (Pb0.05). Lepromatous leprosy cases showed lowest vitamin levels. Conclusion Vitamin levels in leprosy is lower indicating nutritional deficiencies. This deficient state may be an important risk factor for leprosy susceptibility. Keywords: Leprosy, Vitamin, Neuropathy, Mycobacterium leprae doi:10.1016/j.jns.2019.10.1264
WCN19-0998 Journal of the Neurological Sciences 405S (2019) 104927 Poster Session 3 Unihemispheric demyelination-A rare variant of acute disseminated encephalomyelitis
doi:10.1016/j.jns.2019.10.1263 S.C.J. Chandran Kerala Institute of Medical Sciences, Neurology, Thiruvananthapuram, India
WCN19-0993 Journal of the Neurological Sciences 405S (2019) 104926 Poster Session 3 Vitamin A, C, D, E and B12 levels in leprosy: A case control study N. Kumara, H.S. Malhotraa, V. Garga, R.K. Garga, K.P. Malhotrab a King George's Medical University, Neurology, Lucknow, India b Dr. Ram Manohar Lohia Institute Of Medical Sciences, Pathology, Lucknow, India
Background Vitamins are essential part of nutrition and well-being. Many reports indicate that vitamins may influence the etio-pathogenesis of leprosy. Aims We aimed to compare blood vitamin (A, C, D, E and B12) levels in recently diagnosed leprosy patients with healthy controls. Methods We enrolled 60 newly- diagnosed patients of leprosy. We also included age and sex matched control subjects. All patients were categorized according to World Health Organization classification and the Ridley Jopling classification of leprosy. Vitamins A, C, D, E
ADEM is a monophonic inflammatory demyelination of the central nervous system, characterized by scattered focal or multifocal (disseminated) inflammation of the brain and/or spinal cord. We describe three cases of unihemispheric involvement in ADEM. Case 1 A 30-year-old male presented with acute vomiting, right gaze palsy, right LMN facial palsy, and right cerebellar signs. MRI brain showed T2, FLAIR hyperintense lesions involving right half of brainstem, right cerebellum, and posterior limb of the right internal capsule. CSF study was normal. He improved with steroids. Case 2 An 8- year - old boy presented with left focal to secondary generalized seizures and left hemiplegia. He was in coma. MRI Brain showed T2, FLAIR hyperintense lesions involving right half of brainstem, right cerebellum, thalamus, basal ganglia, right cortical gray matter and subcortical white matter. CSF showed elevated protein without pleocytosis. He was intubated and was given pulse methylprednisolone anti edema measures and levitiracetam. He worsened and expired. Case 3 A 30 year old man presented with right focal seizures and right hemiparesis. MRI Brain showed T2 FLAIR hyper intensities involving left frontal temporal and parietal subcortical white matter and left basal ganglia with micro hemorrhages. CSF study was normal. He improved with steroids. Unilateral involvement is rare in ADEM. Relevant literature and differentiation from other unilateral inflammatory diseases will be discussed. doi:10.1016/j.jns.2019.10.1265