ABSTRACT
BACKGROUND: Vitamin B12 deficiency is associated with a wide spectrum of neuro-psychiatric manifestations. RESULTS: We report a case of a 44 year old female patient referred to the haematology unit with vitamin B12 deficiency presenting as an acute confusional state or delirium. Total resolution of the psychiatric symptoms occurred following parenteral vitamin B12 replacement therapy. CONCLUSION: This case report highlights one of the neuro-psychiatric presentations of vitamin B12 deficiency in a previously healthy individual.
Subject(s)
Delirium/etiology , Vitamin B 12 Deficiency/complications , Adult , Delirium/drug therapy , Diagnosis, Differential , Female , Humans , Treatment Outcome , Uganda , Vitamin B 12/administration & dosage , Vitamin B 12 Deficiency/diagnosis , Vitamin B 12 Deficiency/psychology , Vitamin B Complex/administration & dosageABSTRACT
BACKGROUND: We determined the prevalence and factors associated with hyperlactatemia among HIV patients admitted on the emergency ward of a national hospital in Uganda. OBJECTIVE: We were specifically interested in knowing whether there was an association between clinically significant hyperlactatemia and concurrent antiretroviral therapy (ART) use. METHODS: A cross sectional descriptive study enrolled 303 HIV infected patients at a national referral hospital between March and April 2008. We consecutively recruited all eligible HIV infected patients above 18 years admitted on the emergency ward. Data were collected on socio-demographic, clinical and laboratory characteristics. Lactate levels were measured using the Accutrend® portable lactate analyser. Data analysis was performed using Stata 10.0; P-value of < 0.05 was considered to be significant. RESULTS: Three hundred and three HIV infected patients were recruited. Prevalence of hyperlactatemia (lactate ≥2.5mmol/L) was 252 (83.2%). Clinically significant hyperlactatemia (lactate ≥4mmol/L) was present in 105/303(34.6%) patients. There was no association between use of ART and clinically significant hyperlactatemia. In the multivariate analysis, body weakness 1.91 (1.09-3.35), skin rash 3.18 (1.11-9.10) and tachypnoea 1.04 (1.01-1.07) were independently associated with clinically significant hyperlactatemia. CONCLUSION: There was a high prevalence of clinically significant hyperlactatemia among HIV infected patients but it was not associated with concurrent antiretroviral use.