vitamin-b-12 and Calcinosis

Homocysteine has been proposed as a risk factor for atherosclerosis. The association between plasma total homocysteine (tHcy) concentration and carotid atherosclerosis has not been thoroughly studied in high-risk populations with vascular disease. For this study, carotid atherosclerosis was assessed by measurements of carotid intima-media thickness (IMT) and plaque calcification in 923 patients with vascular disease or diabetes. Associations with tHcy and plasma folate concentrations were examined. The mean and single maximum carotid IMT were 1.27 +/- 0.34 mm and 2.41 +/- 0.83 mm, respectively. The mean segment plaque calcification score was 27.8%. tHcy correlated with mean (r = 0.13; p < 0.001) and single maximum (r = 0.12; p < 0.001) carotid IMT. There was a progressive increase in mean and single maximum carotid IMT across quartiles of tHcy (p < 0.0001 for trend). These associations were no longer significant after adjusting for other CV risk factors. A trend towards an inverse association between plasma folate and mean max carotid IMT was found in both univariate and multivariable analyses. However, the plaque calcification score increased across quartiles of tHcy (p < 0.01) and decreased across quartiles of plasma folate concentrations (p < 0.05) after multiple adjustments. In conclusion, in high-risk individuals, tHcy and low folate concentrations were only weakly associated with carotid IMT. In contrast, we found an independent association with the plaque calcification score, a measure of more advanced atherosclerosis. The effect of tHcy lowering on carotid atherosclerosis and stroke prevention warrants further investigation.

Topics: Aged; Biomarkers; Calcinosis; Canada; Cardiovascular Diseases; Carotid Artery Diseases; Carotid Artery, Common; Disease Progression; Drug Combinations; Female; Folic Acid; Homocysteine; Humans; Male; Middle Aged; Prospective Studies; Risk Factors; Tunica Intima; Tunica Media; Ultrasonography; Vitamin B 12; Vitamin B 6; Vitamin B Complex

Fahr's syndrome is characterized by symmetrical and bilateral intracerebral calcifications, located in the basal ganglia and mostly associated with a phosphorus calcium metabolism disorder. It must be distinguished from genetic or sporadic Fahr's disease.. We report two cases of this syndrome, the first was revealed by psychotic and cognitive disorders and the other by epilepsy. In both cases, brain imaging and biology resulted in the diagnosis of Fahr's syndrome. The outcome was favorable after treatment in both cases.. These two observations illustrate various clinical signs of Fahr's syndrome.

Topics: Adult; Aged; Basal Ganglia Diseases; Calcinosis; Calcium; Calcium Metabolism Disorders; Cognition Disorders; Female; Humans; Male; Psychotic Disorders; Syndrome; Tomography, X-Ray Computed; Treatment Outcome; Vitamin B 12; Vitamin D

Steatorrhea due to chronic pancreatitis was found in 23 percent of a consecutive series of 107 new african diabetics; 3 had pancreatic calcification. Of 16, 14 had definitely abnormal exocirne secretion function testing using secreation pancreozymin stimultion. Themorphology and function of the small intestine were normal by local standards. When compared with diabetics without steatorrhea they weighed less, their fasting blood sugars were lower, and their insulin requirements were greater. High alcoholic intake might be significant cause, but the incidence was similar in the diabetics without steatorrhea. No evidence of childhood or adult malnutrition was established. The etiology of this high incidence of chronic pancreatitis among african diabetics remains unexplained.

Topics: Adult; Amylases; Bicarbonates; Calcinosis; Celiac Disease; Chronic Disease; Diabetes Complications; Duodenum; Feces; Female; Humans; Intestinal Absorption; Jejunum; Male; Middle Aged; Pancreatitis; Prospective Studies; Proteins; Vitamin B 12; Xylose; Zimbabwe

A 68-year-old man presenting with chronic intermittent diarrhea and progressive ataxia was found to have idiopathic hypoparathyroidism. Intrinsic factor-resistant vitamin B(12) malabsorption was demonstrated. Both the diarrhea and vitamin malabsorption were reversed by correction of hypocalcemia.His neurological profile was a combination of peripheral nerve, posterior column and cerebellar deficits. He had calcifications in the dentate nuclei of the cerebellum. Possible etiological factors such as vitamin B(12) deficiency, folic acid deficiency and steatorrhea have been excluded. Posterior column and cerebellar abnormalities improved with treatment. It is postulated that hypocalcemia causes functional, reversible spinal cord and cerebellar dysfunction.

Topics: Aged; Calcinosis; Calcium; Cerebellar Diseases; Diarrhea; Humans; Hypocalcemia; Hypoparathyroidism; Male; Peripheral Nervous System Diseases; Phosphorus; Spinal Cord Diseases; Vitamin B 12; Vitamin D