ABSTRACT
Aims: The aim of this study was to investigate thyroid status in Alzheimer’s Disease (AD) patients and its response to donepezil and vitamin B12supplement therapy for 6 months.Design:Case-Control Observational study.Place and Duration:Department of Biochemistry, GGMC & Sir J. J. Group of Hospitals, Mumbai, India between March 2017 and July 2019.Methodology:Case-Control study comprised of 71 AD patients and 70 healthy controls above 60 years of age. Blood serum samples were analyzed forthyroid hormones levels by the chemiluminescence method. AD patients weretreated with donepezil (5mg/day) and vitamin B12supplement (1.5mg/day) and thyroid profile was observed at intervals of 3 and 6 months. Statistical evaluationwas done by using IMB SPSS statistics version 25.Results:Serum levels of thyroid hormones were low in euthyroidAD patients when compared with controls at the baseline level [T3 (120.64 ± 20.64 vs127.8 ± 17.29), T4 (7.71 ± 2.34 vs 7.54 ± 1.85), FT3 (1.2 ± 0.13 vs 2.26 ± 0.63) and FT4 (0.79 ± 0.08 vs 1.29 ± 0.27)]except TSH which was increased in AD [TSH (2.71 ± 1.19 vs 2.34 ± 0.65)]. During follow-ups at 3 and 6 months, there was a slight decrease in TSH levels in response to the therapy.Conclusion: The AD patients were euthyroid with low T3, FT3 and FT4 serum levels and high TSH serum levels. Thyroid hormones might play a role as markers for disease progression. Donepezil and vitamin B12therapy could not benefit restorethe normal thyroid functioning in a period of 6 months. Further longitudinal research with larger cohort might help in elucidating thyroid dysfunction in AD and develop novel therapeutic strategies.
ABSTRACT
Background: The aim of the study was to study the different presentations, treatment patterns and relapses on therapy in patients of neuromyelitis optica (NMO) and neuromyelitis optica spectrum disorder (NMOSD).Methods: This is a retrospective, observational study in a tertiary hospital where Demographics, clinical manifestations at onset and at follow up and relapses, serum anti Aquaporin 4 antibody status, first line immunomodulatory therapy which was initiated and Relapses on first line therapy were noted.Results: Demographics and clinical presentation was largely similar to published data. 80% patients presented with LETM/ON at onset. Ten patients relapsed on oral therapy and trend was to shift from oral therapy to RTX after relapse on oral agent. No relapses were noted on RTX.Conclusions: Unaffordability and apprehension towards injections and cost were the factors affecting IMT decision, so majority received oral agents Aza/ MMF as first line therapy while remaining patients on oral therapy remained relapse free.