ABSTRACT
Posterior reversible encephalopathy syndrome(PRES) is a proposed reversible cliniconeuroradiological entity characterized by headache, altered mental status, cortical blindness, seizures, focal neurological signs and a diagnostic magnetic resonance image showing multiple hyperintense signal in cortical and subcortical white matter. We report a case of 25 year female who presented 2 days postdelivery with posterior reversible encephalopathy syndrome. Early diagnosis with MRI showing bilateral parietal and occipital hyperintensities and treatment with manitol, antiepileptics and supportive measure, the syndrome was fully reversible. Clinicians as well as radiologists should be familiar with this clinically frightening, underdiagnosed condition to assure timely diagnosis and treatment to prevent persistent neurological deficits.
ABSTRACT
A 66 kDa plasma membrane associated molecule of promastigotes of Leishmania donovani (MHOM/IN/1978/UR6) was affinity purified under acidic conditions. Employing purified 66 kDa antigen in micro ELISA, 36 (97.3%) of the 37 patients of visceral leishmaniasis (bone marrow aspirates positive for Leishman Donovan bodies) had detectable levels of anti 66 kDa anti leishmanial antibodies. The sera of the patients confirmed to have visceral leishmaniasis had significantly (P < 0.001) higher optical density values (0.636 +/- 0.230) as compared to sera (OD 0.185 +/- 0.131) from patients clinically suspected to have visceral leishmaniasis (bone marrow aspirates negative for Leishman Donovan bodies). None of the 35 sera from apparently healthy subjects from non endemic area had anti 66 kDa antibodies. However, sera from one (8.3%) of the 12 healthy subjects, who was a first degree relative of a patient of visceral leishmaniasis and residing in an area endemic for visceral leishmaniasis, had anti 66 kDa antibodies. It is felt that detection of anti 66 kDa antibodies in a micro ELISA assay provides a highly sensitive and specific tool for confirming ongoing visceral leishmaniasis.