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Lathyrism

Lathyrism is a term describing a disease that develops after prolonged consumption of grass pea, known as Lathyrus sativus. The pathogenesis involves axonal degeneration of motor neurons and subsequent spastic paraparesis due to the introduction of neurotoxins from this food. The condition was rather common in Ethiopia, as well as India and surrounding countries, but is now rarely documented. The diagnosis rests on clinical criteria and findings obtained during history taking.


Presentation

Lathyrism, considered to be a rare occurrence in clinical practice today, is a disease arising due to prolonged and excessive consumption of Lathyrus sativus legume, more commonly known as grass pea or chickling pea [1] [2] [3]. In limited concentrations, L. sativus is a part of the normal diet in many countries and lathyrism usually appears in times of profound famine from severe droughts or floods, as the legume can survive extremely dry conditions and tolerates floods as well [2] [3] [4]. Although previously documented throughout the world, three countries have reported the vast majority of cases in the previous decades - Ethiopia, Bangladesh, and India [1] [2] [4] [5] [6]. Lathyrism stems from ingestion of a neurotoxic excitatory beta-N-oxalylamino-L-alanine amino acid (BOAA) during droughts in very high amounts for at least a few months, and the term "staple diet" is often used to describe the excessive dietary intake of a certain food [5] [7]. BOAA seems to directly promote symmetric degeneration of anterior horn cells and upper motor neurons in the spinal cord, as well as pyramidal cells responsible for leg movement located in the primary motor cortex [3] [5] [7], with inhibition of mitochondrial activity being the presumable mechanism of disease [6]. Consequently, the principal clinical manifestation of lathyrism is non-progressive spastic paraparesis of the lower limbs [1] [2] [5]. In addition to neurotoxic effects, some studies have identified bone pain as a symptom of lathyrism and marked skeletal changes on radiographic studies [8].

Spastic Paralysis
  • […] lath·y·rism \ ˈla-thə-ˌri-zəm \ : a neurotoxic disorder chiefly affecting people and domestic animals (such as cows and horses) that is characterized especially by irreversible spastic paralysis of the hind or lower limbs and that results from poisoning[merriam-webster.com]
  • Retrieved November 21st, 2018, from lathyrism noun A disease of humans and animals caused by eating legumes of the genus Lathyrus and characterized by spastic paralysis, hyperesthesia, and paresthesia.[yourdictionary.com]
  • Pathol. a disorder of humans and domestic animals caused by ingestion of the seeds of some legumes of the genus Lathyrus and marked by spastic paralysis and pain.[dictionary.infoplease.com]
  • Neurolathyrism is a crippling disease characterized by gradually developing spastic paralysis of lower limbs, occurring mostly in adults consuming pulse, Lathyrus sativus in large quantities over a period of time for 2 months or more. c.[gradestack.com]
Hyperesthesia
  • Definitions lath·y·rism a painful, poisoned condition caused by the ingestion of certain peas (esp. genus Lathyrus ) and characterized by paralysis of the legs, hyperesthesia, etc.[yourdictionary.com]
  • Copyright HarperCollins Publishers lathyrism in American ( ˈlæθəˌrɪzəm ; la t h ˈərizˌəm ) noun a painful , poisoned condition caused by the ingestion of certain peas (esp. genus Lathyrus ) and characterized by paralysis of the legs, hyperesthesia, etc[collinsdictionary.com]
  • Hyperesthesia. . Paresthesia. . Angiolathyrism - causes sudden death. . Aneurisms. . Osteolathyrism - affects skeletal development, cartilages and bones grow abnormally - deformity of the body. . Development of brain stops.[specialityclinic.com]
  • (genus ... (23 of 66 words, pronunciations) www.merriam-webster.com/dictionary/lathyrism American Heritage Dictionary: lathyrism A disease of humans and animals caused by eating legumes of the genus "Lathyrus" and characterized by spastic paralysis, hyperesthesia[memidex.com]
Spastic Paraplegia
  • Progressive spastic paraplegia. . Pain. . Hyperesthesia. . Paresthesia. . Angiolathyrism - causes sudden death. . Aneurisms. . Osteolathyrism - affects skeletal development, cartilages and bones grow abnormally - deformity of the body. .[specialityclinic.com]
  • Main involvement is spastic paraplegia with exaggerated tendon jerks and extensor response plantar. Predominantly there is involvement of the cord between T12 and Li segments. The upper limbs usually escape and there is no wasting of muscles.[healthdrip.com]
  • The clinical manifestation of human T-cell leukemia/lymphoma virus type-1/topical spastic paraplegia is similar to konzo and neurolathyrism, and this neurologic disease has been considered a differential diagnosis of konzo and neurolathyrism.[medlink.com]
Paresthesia
  • Retrieved November 21st, 2018, from lathyrism noun A disease of humans and animals caused by eating legumes of the genus Lathyrus and characterized by spastic paralysis, hyperesthesia, and paresthesia.[yourdictionary.com]
  • Paresthesia. . Angiolathyrism - causes sudden death. . Aneurisms. . Osteolathyrism - affects skeletal development, cartilages and bones grow abnormally - deformity of the body. . Development of brain stops. Dietary management for Lathyrism .[specialityclinic.com]

Workup

The diagnosis of lathyrism might be difficult to make without a properly obtained patient history and a complete neurological examination. A thorough nutritional assessment, during which ingestion of grass pea or chickling pea should be investigated, might be of critical importance, and some studies have confirmed that consumption of boiled or raw unripe grass pea significantly increases the risk of neurological symptoms [2]. Because famine and droughts are regarded as necessary events for lathyrism to appear [2] [3], epidemiological data are equally useful in order to make a provisional diagnosis. For the still unknown reason, males more commonly suffer from lathyrism compared to females [3]. The neurological assessment must include reflex testing and evaluation of movement, particularly of the lower extremities, and in the case of spastic paraparesis or even paralysis, clinical suspicion can be raised toward lathyrism. When bone pain is reported, plain radiography might be suggested, as skeletal deformities have been documented [8]. As no specific tests exist, the diagnosis of lathyrism depends on the ability of the physician to recognize main signs of the disease and support those findings with information from the patient interview.

Treatment

  • Further, compression tests revealed a significant negative impact of β-APN treatment on maximal force to failure and energy to failure, while stiffness was not influenced. Bone mineral density distribution (BMDD) was not altered either.[ncbi.nlm.nih.gov]
  • Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. For details see our conditions .[patient.info]
  • Treatment of lathyrism There is no specific treatment once it develops Analgesics, generous diet and large doses of Vitamin B complex may help. Patient should avoid damp and wet climate.[healthdrip.com]
  • There are three possible approaches for the eradication of the disease: Treatment of the seed by leaching out the toxic factors in hot water both on home scale and factory scale.[layman-health.blogspot.com]

Prognosis

  • Prognosis of lathyrism depends on the stage at which the patient presents. Views: 2,771[healthdrip.com]

Epidemiology

  • A door-to-door epidemiological survey for the disease using trained lay health workers was carried out in the major areas of northwest and central Ethiopia where L. sativus is grown.[ncbi.nlm.nih.gov]
  • Epidemiology The chickling pea flourishes in conditions of both flood and drought, when no other food crop survives. It has been the traditional survival food of the poor in some developing countries.[patient.info]
  • In this article, the author provides updated information on epidemiology, clinical features, differential diagnosis, and management of lathyrism, konzo, and tropical ataxic neuropathy.[medlink.com]
  • ., 1964, An epidemiological study of lathyrism in the district of Rewa, Madhya, Pradesh, Indian J. Med. Res . 1 : 81. Google Scholar Ganapathy, K.[link.springer.com]
Sex distribution
Age distribution

Prevention

  • Production and consumption of grass-pea is increasing in Ethiopia, making attempts to develop low-BOAA strains to prevent lathyrism increasingly important.[ncbi.nlm.nih.gov]
  • The prevention of lathyrism is therefore a socio-economic challenge. Treatment [ edit ] This section is empty. You can help by adding to it .[en.wikipedia.org]
  • Prevention Public health education about the dangers of lathyrism is obviously important but the harsh reality is that people may face a choice between lathyrism or starvation .[patient.info]
  • Its aetiology and prevention. Journal of Nutrition and Dietetics, 3. pp. 100-103.[ir.cftri.com]

References

Article

  1. Spencer PS, Schaumburg HH. Lathyrism: a neurotoxic disease. Neurobehav Toxicol Teratol. 1983;5(6):625-629.
  2. Getahun H, Lambein F, Vanhoorne M, Van der Stuyft P. Food-aid cereals to reduce neurolathyrism related to grass-pea preparations during famine. Lancet. 2003;362:1808–1810.
  3. Getahun H, Lambein F, Vanhoorne M, Van der Stuyft P. Neurolathyrism risk depends on type of grass pea preparation and on mixing with cereals and antioxidants. Trop Med Int Health. 2005;10(2):169-178.
  4. Singh SS, Rao SLN. Lessons from neurolathyrism: A disease of the past & the future of Lathyrus sativus (Khesari dal). Indian J Med Res. 2013;138(1):32-37.
  5. Haimanot RT, Kidane Y, Wuhib E, et al. The epidemiology of lathyrism in north and central Ethiopia. Ethiop Med J. 1993;31(1):15-24.
  6. Haimanot RT, Kidane Y, Wuhib E, et al. Lathyrism in rural northwestern Ethiopia: a highly prevalent neurotoxic disorder. Int J Epidemiol. 1990;19(3):664-672.
  7. Ravindranath V. Neurolathyrism: mitochondrial dysfunction in excitotoxicity mediated by L-beta-oxalyl aminoalanine. Neurochem Int. 2002;40(6):505-509.
  8. Haque A, Hossain M, Lambein F, Bell EA. Evidence of osteolathyrism among patients suffering from neurolathyrism in Bangladesh. Nat Toxins. 1997;5(1):43-46.

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Last updated: 2017-08-09 18:03