ABSTRACT
We report a case of Sweet's syndrome associated with retinoic acid syndrome in a patient with acute promyelocytic leukemia treated with all- trans retinoic acid (ATRA). Sweet's syndrome appeared on day 6 of ATRA therapy for promyelocytic leukemia. It was associated with a mild retinoic acid syndrome, an inflammatory syndrome occurring in 25% of patients treated with ATRA and characterized by features of capillary leakage with systemic inflammatory signs. The ATRA therapy was discontinued for 11 days and treatment with corticosteroids improved the systemic and cutaneous signs. Only 11 cases of Sweet's syndrome associated with ATRA have been previously reported in the literature, involving only the skin in eight cases, the skin and muscles in two cases, and the lung, kidney, fascia, and muscles in one case. Sweet's syndrome was followed by retinoic acid syndrome in one of these cases. The previously reported cases are reviewed, and the mechanisms of Sweet's and retinoic acid syndromes and the link between them are discussed.
Subject(s)
Antineoplastic Agents/adverse effects , Leukemia, Promyelocytic, Acute/drug therapy , Sweet Syndrome/chemically induced , Tretinoin/adverse effects , Antineoplastic Agents/therapeutic use , Fever/chemically induced , Humans , Male , Middle Aged , Syndrome , Tretinoin/therapeutic use , Weight GainABSTRACT
Nutritional factors are integrally linked with Alzheimer's disease (AD). Although AD patients have no changes in energy metabolism, fluctuations in weight are fairly common. The potential role of vitamin B(12) and folate, with the production of hyperhomocysteinemia, in the pathophysiology of AD is explored. The role of free-radical damage in AD is discussed. It is stressed that alterations in dietary lipids may play an important role in cognitive defects in AD secondary to their effects on neuronal membrane lipids. More research is needed on the role of nutrition in the ongoing development of cognitive changes in AD.
Subject(s)
Alzheimer Disease/physiopathology , Nutritional Physiological Phenomena , Aged , Alzheimer Disease/pathology , Alzheimer Disease/therapy , Amyloid beta-Protein Precursor/metabolism , Animals , Anticholesteremic Agents/pharmacology , Avitaminosis/metabolism , Cholesterol/metabolism , Cholesterol, Dietary/administration & dosage , Diet , Dietary Fats/administration & dosage , Energy Metabolism , Humans , In Vitro Techniques , Nutritional Status , Oxidative Stress , Weight LossABSTRACT
Amongst factors associated with the institutional placement of elderly people with dementia, there has been little study of those related to malnutrition. We followed a cohort of 318 individuals with Alzheimer's disease (AD). Patients, who were all living at home at the start of the study were recruited from the outpatient service of a hospital unit specialising in AD. After one year, 20% of the patients had moved into institutional care. Multivariate analysis showed that a Mini nutritional Assessment score (MNA) of less than 25.5 (median score of the sample) and overeating behavioural problems (p=0.006) were risk factors for institutional placement. Nutritional problems are reversible and patients with a low MNA score could benefit from a thorough geriatric assessment, in order to slow or prevent institutional placement.
