Brief Answer:
Yes, both labs and dementia can be explained

Detailed Answer:
Hi,

Thanks for posting your query. I have read it with diligence, and I am sorry about your current health status.

Your concern is about the recent onset dementia. I shall discuss about it sooner.

I am glad the vitamin B12 shots are increased in you. This will definitely help the brain and the nerves.

The old labs that you found were of the serum immunoglobulin levels mostly. I see that it indicates serum IgG, IgM levels that are low. When was this tests done? What was the reason behind the testing?

You also seem to have fatty liver with elevated AST and ALT but can't find the report now. That is not a problem; it is fine with me.

I would be interested to know more about this degenerative neurological disorder with dystonia and myoclonus, that you are currently suffering with. In my view, perhaps this is somewhere leading to the recent onset dementia in you.

Your answers:

The low levels of serum immunoglobulins represent a defective immunity in you. This can be attributed to the MS like condition that you have.

The fatty liver is a usual finding in women of your age. It can be attributed to your non-ambulatory status, and lack of physical activity. I do not blame you for this. You have a valid medical condition that restricts you from doing so. I am sorry about it.

Mild fatty liver is negligible clinically. Nothing needs to be done unless it becomes symptomatic.

The only reason that I can think of about your dementia is the degenerative disorder accompanied with MS like condition. These conditions definitely wear off the nerve cells in the brain, and gradually you tend to lose them causing dementia.

I would like to discuss more about this from your end. Please do write back.

Regards,

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Brief Answer:
Detailed below

Detailed Answer:
Hi,

Thanks for writing back; I have been studying your case too since last evening.

I could think of these possibilities for your labs.

The work up that was done 10 years ago was perhaps for an autoimmune problem in you. The serum levels of IgG, IgM were tested.

You seem to have a long history of yeast and bacterial infections.

Here are the possibilities that I think of:

Congenital immunodeficiency syndromes like Congenital Hypogammaglobulinemia. This means a defect or low levels of immunoglobulin G and M since birth itself. This leads to defective immunity and recurrent infections.

It could also be complete Agammaglobulinemia where is there is total absence of immunoglobulins.

The third possibility is complement deficiency like C1q deficiency, which manifests like Lupus, rhematoid disease, and infections. Another cause is C3 deficiency.

Going by these, I think you have had a deficiency of immunoglobulins all through your life, causing recurrent infections and general debility.

Eventually, the idiopathic anaphylaxis developed too.

Coming to the liver test at ALT of 93 and AST of 58, both these values are clinically insignificant. These values are important only when they run in several hundreds in number.

Your liver is normal. There is nothing wrong with it.

A liver diet would include complete no-fat diet, low-carbohydrate and low-protein diet, with more of green leafy vegetables and salads, and fruits.

Remitting MS is a problem by itself. It needs patient education, and lifestyle modifications depending on the need.

Hope this gives you an insight into your problem. Let me know if you have more queries.

Regards,

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