Table 1.
Pt 1 (M) | Pt 2 (M) | Pt 3 (M) | Pt 4 (M) | Pt 5 (F) | |
---|---|---|---|---|---|
ACUTE EPISODE |
|
||||
Age at fatal acute episode |
45 y |
44 y |
21 y |
66 y |
34 y |
Duration of fatal episode |
9 d |
30 d |
15 d |
5 d |
22 d |
Duration of coma |
7 d |
1 d (first coma); 7 d (second coma) |
12 d |
2 d |
20 d |
FAMILY HISTORY OF METABOLIC DISORDERS |
Negative |
Negative |
Negative |
Negative |
Negative |
PAST MEDICAL HISTORY |
Cholecystectomy; Crohn disease; Carpal tunnel syndrome; Sciatica |
Chronic Hepatitis B with fluctuating hypertransaminasemia and prothrombin deficiency |
Negative |
Hypertension; Colon cancer (colectomy and oxaliplatin and capecitabine drugs); Hiccup after chemotherapy |
Drowsiness during menstruation |
DIET PRACTISE |
Regular |
Vegetarian |
Diet rich in vegetables |
Diet rich in vegetables |
Regular |
PROBABLE TRIGGERING EVENT |
Cortisone therapy for joint pains |
Diet change and poor feeding (8 kg lost in a month) after dental surgery |
Diet change: a meal of fish in a Chinese restaurant |
Chemotherapy (Oxaliplatin, Capecitabine) |
Infertility hormone therapy and ICSI-ET, but without an ongoing pregnancy |
MISDIAGNOSIS AT ONSET |
Depression; Unspecified hepatopathy |
Infectious disease; Intestinal pseudo-obstruction; Portosystemic shunts |
Poisoning; Infectious diseases; Drug abuse |
Poisoning; Ischemia; Cancer; Hepatitis |
Narcolepsy; Cancer |
SIGN AND SYMTOMS OF ACUTE EPISODE |
|
||||
Abdominal pain/Vomiting |
No/Yes |
Yes/Yes |
Yes/Yes |
No/No |
No/No |
Headache/Vertigo |
Yes/Yes |
No/Yes |
No/No |
No/Yes |
No/No |
Fever |
No |
Yes |
No |
No |
Yes |
Food refusal |
Yes |
Yes |
No |
No |
No |
Seizures |
No |
Yes |
No |
Yes |
Yes |
Hepatomegaly |
No |
No |
No |
Mild |
No |
Consciousness disturbances | Confusion; Drowsiness; Coma (2 d after onset) | Irritability; Confusion; Coma lasting 24 hours (5 d after onset); Subsequent coma (20 d after) | Confusion; Drowsiness; Coma (3 d after onset) | Slurred speech; Confusion; Hallucinations; Drowsiness; Coma (3 d after onset) | Drowsiness; Coma (2 d after onset) |
Abbreviations: M male, F female, y years, d days, ICSI-ET intra cytoplasmatic sperm injection - embryo transfer.