Steroid sensitive polyneuropathy

Sacks et al. (2005) reported the case of a 72-year-old man, described as professionally successful, intelligent, and cultivated, with polymyalgia rheumatica, who after being treated with prednisone developed a psychosis and dementia , which several behavioral neurology and neuropsychiatry consultants initially diagnosed as early dementia or Alzheimer's disease . [13] Large dosage variations in the patient's medication (including a self-increased dosage from 10 mg/day to as much as 100 mg/day for at least 3 months) produced extreme behavioral changes, from missed appointments to physical altercations, and eventually admission to a psychiatric ward and later to a locked Alzheimer facility. During this time, neuropsychological testing showed a decline in the patient's previously superior IQ as well as deficits in memory, language, fluency, and visuospatial function, which given the patient's age was considered to be compatible with early dementia. When the steroid treatment ended after a year, the patent's confusion and disorganized appearance stopped immediately. Within several weeks, testing showed strong improvement in almost all cognitive functions. His doctors were surprised at the improvement, since the results were inconsistent with a diagnosis of dementia or Alzheimer's. Testing after 14 months showed a large jump in Full Scale IQ from 87 to 124, but mild dysfunction in executive function, memory, attentional control, and verbal/nonverbal memory remained. [13]

The early steps in the biosynthesis of steroids of both plants and animals are the same, except that in plants lanosterol is replaced by the related compound cycloartenol, which contains a three-membered ring (C9, C10, C19) in lieu of the nuclear double bond of lanosterol. The side chains of the phytosterols, such as stigmasterol, and of the sterol ergosterol of yeasts and other fungi contain extra carbon atoms that are incorporated in reactions involving S -adenosylmethionine, which donates methyl groups in numerous biological processes. Although most plant tissues contain only traces of cholesterol, this sterol is the biogenetic precursor of such important plant steroids as the sapogenins , glycosides , and alkaloids . Because pregnane derivatives are intermediates in some of these transformations, plants and animals appear to have important features of steroid metabolism in common.

Steroid sensitive polyneuropathy

steroid sensitive polyneuropathy


steroid sensitive polyneuropathysteroid sensitive polyneuropathysteroid sensitive polyneuropathysteroid sensitive polyneuropathysteroid sensitive polyneuropathy