Blindness Caused by a Junk Food Diet
Authors: Rhys Harrison, Vicki Warburton, Andrew Lux, Denize Atan
Journal: Annals of Internal Medicine (2020)

Letters21 April 2020Blindness Caused by a Junk Food DietRhys Harrison, Vicki Warburton, PhD, Andrew Lux, PhD, and Denize Atan, PhDRhys HarrisonBristol Eye Hospital, University Hospitals Bristol NHS Foundation Trust, Bristol, United Kingdom (R.H.)Search for more papers by this author, Vicki Warburton, PhDUniversity Hospitals Bristol NHS Foundation Trust, Bristol, United Kingdom (V.W.)Search for more papers by this author, Andrew Lux, PhDBristol Royal Hospital for Children, University Hospitals Bristol NHS Foundation Trust, Bristol, United Kingdom (A.L.)Search for more papers by this author, and Denize Atan, PhDBristol Eye Hospital, University Hospitals Bristol NHS Foundation Trust, and Bristol Medical School, University of Bristol, Bristol, United Kingdom (D.A.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L20-0016 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:To understand the importance of our patient's low-normal vitamin B12 levels and clinical history of poor diet, we measured his total Hcy and MMA levels; both were mildly elevated. In a targeted strategy to investigate causes of homocystinuria, we use Hcy levels as a guide to the likely cause (1). Inherited metabolic disorders (IMDs) are rare, generally present in early infancy or childhood, and are normally associated with Hcy levels greater than 100 µmol/L (1). Our patient's Hcy levels were less than 50 µmol/L at presentation, and the most common cause of such a finding is delayed sample ...References1. Refsum H, Smith AD, Ueland PM, et al. Facts and recommendations about total homocysteine determinations: an expert opinion. Clin Chem. 2004;50:3-32. [PMID: 14709635] CrossrefMedlineGoogle Scholar2. Sloan JL, Carrillo N, Adams D, et al. Disorders of intracellular cobalamin metabolism. In: Adam MP, Ardinger HH, Pagon RA, et al, eds. GeneReviews. Seattle: University of Washington, Seattle; 1993. Google Scholar3. Trakadis YJ, Alfares A, Bodamer OA, et al. Update on transcobalamin deficiency: clinical presentation, treatment and outcome. J Inherit Metab Dis. 2014;37:461-73. [PMID: 24305960] CrossrefMedlineGoogle Scholar4. Huemer M, Scholl-Bürgi S, Hadaya K, et al. Three new cases of late-onset cblC defect and review of the literature illustrating when to consider inborn errors of metabolism beyond infancy. Orphanet J Rare Dis. 2014;9:161. [PMID: 25398587] CrossrefMedlineGoogle Scholar5. Sechi G, Sechi E, Fois C, et al. Advances in clinical determinants and neurological manifestations of B vitamin deficiency in adults. Nutr Rev. 2016;74:281-300. [PMID: 27034475] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Bristol Eye Hospital, University Hospitals Bristol NHS Foundation Trust, Bristol, United Kingdom (R.H.)University Hospitals Bristol NHS Foundation Trust, Bristol, United Kingdom (V.W.)Bristol Royal Hospital for Children, University Hospitals Bristol NHS Foundation Trust, Bristol, United Kingdom (A.L.)Bristol Eye Hospital, University Hospitals Bristol NHS Foundation Trust, and Bristol Medical School, University of Bristol, Bristol, United Kingdom (D.A.)Disclosures: Authors have disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L19-0361. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoBlindness Caused by a Junk Food Diet Rhys Harrison , Vicki Warburton , Andrew Lux , and Denize Atan Blindness Caused by a Junk Food Diet Alison M.R. Castle , Pranesh Chakraborty , and Michael Geraghty Metrics Cited by58. Case ReportNeurobiology of Avoidant/Restrictive Food Intake Disorder in Youth with Overweight/Obesity Versus Healthy Weight 21 April 2020Volume 172, Issue 8Page: 575-576KeywordsCobalaminsDietFolic acidOptic neuropathyPhenotypesRetinopathyVisionVitamin B12 deficiencyVitamin DVitamin D deficiency ePublished: 21 April 2020 Issue Published: 21 April 2020 Copyright & PermissionsCopyright © 2020 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...