Obstrução arterial retiniana periférica associada com hiper-homocisteinemia: relato de caso

Misawa, Alexandre Kazuo; Suzuki, Hisashi; Júnior, Otacílio de Oliveira Maia; Bonanomi, Maria Teresa Brizzi Chizzotti; Melo, Carlos Sérgio Nascimento de

doi:10.1590/s0004-27492008000500024

Cited by 5 publications

(2 citation statements)

References 20 publications

(31 reference statements)

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“…Because elevated Hcy levels are associated with coronary and peripheral vascular obstructive events (Misawa et al 2008), the variant alleles of the MTHFR gene could contribute, in the course of time, to a lower oxygen supply to the heart in those endurance athletes who exercise strenuously, reducing cardiovascular fitness and thus performance, since they have been associated with increased Hcy. In fact, MTHFR C677T polymorphism has been associated with lower hemoglobin level in a healthy exercise-trained population (Fortunato et al 2007).…”

Section: Discussionmentioning

confidence: 99%

Creatine kinase MM TaqI and methylenetetrahydrofolate reductase C677T and A1298C gene polymorphisms influence exercise-induced C-reactive protein levels

et al. 2011

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Physical training induces beneficial adaptations, but exhausting exercise increases reactive oxygen species, which can cause muscular injuries with consequent inflammatory processes, implying jeopardized performance and possibly overtraining. Acute strenuous exercise almost certainly exceeds the benefits of physical activity; it can compromise performance and may contribute to increased future risk of cardiovascular disease (CVD) in athletes. Polymorphisms in the muscle-type creatine kinase (CK-MM) gene may influence performance and adaptation to training, while many potentially significant genetic variants are reported as risk factors for CVD. Therefore, we investigated the influence of polymorphisms in CK-MM TaqI and NcoI, methylenetetrahydrofolate reductase (MTHFR C677T and A1298C) and C-reactive protein (CRP G1059C) genes on exercise-induced damage and inflammation markers. Blood samples were taken immediately after a race (of at least 4 km) that took place outdoors on flat tracks, and were submitted to genotyping and biochemical evaluation of aspartate aminotransferase (AST), CK, CRP and high-sensitivity CRP (hs-CRP). CK-MM TaqI polymorphism significantly influenced results of AST, CK and hs-CRP, and an association between MTHFR C677T and A1298C with CRP level was found, although these levels did not exceed reference values. The results indicate that these polymorphisms can indirectly influence performance, contribute to higher susceptibility to exercise-induced inflammation or protection against it, and perhaps affect future risks of CVD in athletes.

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Section: Discussionmentioning

confidence: 99%

Creatine kinase MM TaqI and methylenetetrahydrofolate reductase C677T and A1298C gene polymorphisms influence exercise-induced C-reactive protein levels

et al. 2011

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“…Because elevated Hcy levels are associated with coronary and peripheral vascular obstructive events (Misawa et al 2008), the variant alleles of the MTHFR gene could contribute, in the course of time, to a lower oxygen supply to the heart in those endurance athletes who exercise strenuously, reducing cardiovascular Wtness and thus performance, since they have been associated with increased Hcy. In fact, MTHFR C677T polymorphism has been associated with lower hemoglobin level in a healthy exercise-trained population (Fortunato et al 2007).…”

Section: Discussionmentioning

confidence: 99%

Creatine kinase MM TaqI and methylenetetrahydrofolate reductase C677T and A1298C gene polymorphisms influence exercise-induced C-reactive protein levels

Miranda-Vilela¹,

Akimoto²,

Lordelo³

et al. 2011

Eur J Appl Physiol

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Physical training induces beneficial adaptations, but exhausting exercise increases reactive oxygen species, which can cause muscular injuries with consequent inflammatory processes, implying jeopardized performance and possibly overtraining. Acute strenuous exercise almost certainly exceeds the benefits of physical activity; it can compromise performance and may contribute to increased future risk of cardiovascular disease (CVD) in athletes. Polymorphisms in the muscle-type creatine kinase (CK-MM) gene may influence performance and adaptation to training, while many potentially significant genetic variants are reported as risk factors for CVD. Therefore, we investigated the influence of polymorphisms in CK-MM TaqI and NcoI, methylenetetrahydrofolate reductase (MTHFR C677T and A1298C) and C-reactive protein (CRP G1059C) genes on exercise-induced damage and inflammation markers. Blood samples were taken immediately after a race (of at least 4 km) that took place outdoors on flat tracks, and were submitted to genotyping and biochemical evaluation of aspartate aminotransferase (AST), CK, CRP and high-sensitivity CRP (hs-CRP). CK-MM TaqI polymorphism significantly influenced results of AST, CK and hs-CRP, and an association between MTHFR C677T and A1298C with CRP level was found, although these levels did not exceed reference values. Results indicate that these polymorphisms can indirectly influence performance, contribute to higher susceptibility to exercise-induced inflammation or protection against it, and perhaps affect future risks of CVD in athletes.

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Diagnostic and Therapeutic Challenges

Garg¹,

Agarwal²,

Singh³

et al. 2012

Retina

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A 33-year-old man came to our hospital with gradually progressive blurring of vision in the left eye for 2 months. He complained of micropsia and altered color perception in the left eye for 10 days and pain in the left eye for 5 days to 6 days. He was diagnosed with essential hypertension for the past 1 year and was on treatment (tablet Telmisartan 40 mg once daily orally). His best-corrected vision was 6/6 and 6/9 in the right and left eyes, respectively. The intraocular pressure was 14 mmHg and 15 mmHg in right and left eyes, respectively. Color vision was recorded with Ishihara plates and was 38/38 in both eyes. The anterior chamber angle was open in both the eyes. Slit-lamp examination was normal in both eyes. The right eye fundus was within normal limits and left eye fundus revealed sea-fan neovascularization with feeder vessels in the inferotemporal quadrant with localized tractional retinal detachment ( Figure 1, A-C).Spectral-domain optical coherence tomography (Optovue RT-Vue 100) was done; the fovea in both eyes was normal. An epiretinal membrane was present away from the fovea. Optical coherence tomography through the lesion revealed tractional retinal detachment with an intact retinal pigment epithelium layer. Fluorescein angiography was done revealing leakage and staining (Figure 1, D and E). ultrasound/ultrasonogram (USG) Bscan of both eyes was within normal limits. Visual field testing was done (24-2 and 10-2) and was within normal limits. Systemic investigations revealed positive Mantoux, slightly elevated serum glutamic pyruvic transaminase (SGPT), increased erythrocyte sedimentation rate (ESR) and elevated eosinophils (7.6%), and a platelet count was within normal limits. Plasma homocysteine was elevated (18.9 mmole/L). Sickling phenomenon was negative. Bleeding time (BT), clotting time (CT), prothrombin time (PT), and partial thromboplastin time (PTT) were all within normal limits. USG abdomen pelvis revealed generalized fatty infiltration of the liver with right nephrolithiasis. Magnetic resonance imaging brain with contrast showed no significant brain parenchymal abnormality.This case is presented for discussion of diagnosis and management. Drs. Leanne T. Labriola and Amani A. Fawzi (Los Angeles, California):The authors present an interesting case of a 33-yearold hypertensive man, who developed gradual, progressive vision loss in the left eye for 2 months associated with altered color perception for 10 days and left eye pain for 5 days to 6 days. On examination his visual acuity was reduced to 20/30 in his left eye, but his color vision on Isihara color plates was normal. His ocular examination was unremarkable except for the presence of a sea-fan neovascularization in the periphery of his left eye with localized tractional retinal detachment.Testing revealed no evidence of sickling phenomenon. He had elevation of ESR, SGPT (alanine transaminase), and homocysteine levels but platelet and blood clotting times were normal. The Mantoux test (tuberculin sensitivity test) was positive. Imaging sh...

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Obstrução arterial retiniana periférica associada com hiper-homocisteinemia: relato de caso

Cited by 5 publications

References 20 publications

Creatine kinase MM TaqI and methylenetetrahydrofolate reductase C677T and A1298C gene polymorphisms influence exercise-induced C-reactive protein levels

Creatine kinase MM TaqI and methylenetetrahydrofolate reductase C677T and A1298C gene polymorphisms influence exercise-induced C-reactive protein levels

Creatine kinase MM TaqI and methylenetetrahydrofolate reductase C677T and A1298C gene polymorphisms influence exercise-induced C-reactive protein levels

Diagnostic and Therapeutic Challenges

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