Frontal Lobe Like Syndrome Due To Bee Sting
Küçük Resim Yok
Tarih
2014
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Journal Neurological Sciences
Erişim Hakkı
info:eu-repo/semantics/closedAccess
Özet
A 34 year-old male beekeeper experienced flushing, breathing difficulty and loss of consciousness five minutes after he got stung by a honeybee. He was admitted to a local emergency room with hypotension and a phyliform pulse. After a 24-hour period of unresponsiveness, the patient gained consciousness and was discharged home. Two weeks later however, the patient presented with slowing of speech, personality and behavioral changes and difficulty in resolving personal needs such as dressing. Neuropsychological assessment revealed deficits in attention, concentration, executive function, recall memory, organization and coordination and slurred speech. Cranial MRI revealed marked symmetrical hyperintense lesions involving bilateral lentiform and caudate nuclei. Skin prick tests to hymenoptera species were negative. Specific IgE levels were also undetectable. The patient's baseline tryptase level was 49 ng/mL (normal <14.1 ng/ml). Bone marrow biopsy showed dense compact mast cell aggregates in CD117 (c-kit) and tryptase stained sections. Co-expression of CD25 and CD2 were identified on mast cells by flow cytometry. An activating somatic codon Asp816 -> Val KIT mutation was detected in mast cells but not in neutrophils. Based on these findings, diagnosis of systemic mastocytosis was made. This patient represents the first case in English literature who was diagnosed with sytemic mastocytosis and frontal lobe syndrome. Frontal lobe dysfunction may emerge with bilateral basal ganglia lesions. Mast cell degranulation has been documented to enhance vascular permeability and to regulate blood-brain barrier permeability. Besides probable hypoxic encephalopathy, the increased tendency for mast cells to undergo spontaneous degranulation can be explanatory for vasogenic edema in systemic mastocytosis.
Açıklama
Anahtar Kelimeler
Bee sting, bee venom allergy, systemic mastocytosis, frontal lobe syndrome
Kaynak
Journal of Neurological Sciences-Turkish
WoS Q Değeri
Q4
Scopus Q Değeri
Cilt
31
Sayı
2
