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Homocystinemia and stroke in vegetarians
Mohammed A Saadah1, Mona C Thakre, Loai M Saadah
1Neurology Department, Rashid Hospital, PO Box 4545, Dubai, United Arab Emirates. Tel. +971 504575459. Fax. +971 43365333.
Neurosciences (Riyadh, Saudi Arabia)
|January 24, 2012
Summary
Elevated homocysteine, linked to low vitamin B12, can cause stroke in young vegetarians. Polyvitamin therapy may reduce stroke risk by normalizing homocysteine levels.
Area of Science:
- Neurology
- Metabolic Disorders
- Vascular Medicine
Background:
- Homocysteine is a key thiol metabolite.
- High homocysteine (homocysteinemia) is an independent, treatable risk factor for vascular disease, including ischemic stroke.
- Polyvitamin therapy can normalize homocysteine and reduce stroke incidence.
Purpose of the Study:
- To investigate the role of elevated homocysteine and vitamin B12 deficiency in young vegetarians presenting with stroke.
- To highlight the importance of considering these factors in patients without traditional vascular risk factors.
Main Methods:
- Case report of two young strict vegetarians with ischemic stroke.
- Clinical evaluation including assessment of vascular risk factors.
- Laboratory investigations for homocysteine and vitamin B12 levels.
Main Results:
- Both patients presented with ischemic stroke (middle cerebral artery infarct and multiple small cerebral infarctions).
- Investigations revealed moderately elevated homocysteine and low serum B12 levels.
- No other traditional vascular risk factors were identified.
Conclusions:
- Elevated homocysteine due to vitamin B12 deficiency may be an underlying cause of stroke in young strict vegetarians.
- A high index of suspicion for homocysteinemia and B12 deficiency is crucial in young stroke patients lacking conventional risk factors.
- Early diagnosis and polyvitamin therapy can be effective in managing this condition and preventing recurrent stroke.
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