Unexplained multi-sensory neuropathy syndrome in young Tanzanian adults
# Background A unique syndrome affecting young adults of unexplained hearing loss often associated with uncorrectable poor visual acuity and lower extremity numbness is endemic in Dar es Salaam. This study characterised the hearing loss, associated it with other symptoms, and gathered information on...
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| Format: | Article |
| Language: | English |
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Inishmore Laser Scientific Publishing Ltd
2021-03-01
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| Series: | Journal of Global Health Reports |
| Online Access: | https://doi.org/10.29392/001c.21360 |
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| author | Enica R. Massawe Ndeserua Moshi Junkun Ren Catherine C. Rieke Albert K. Magohe Abigail M. Fellows Enat A. Arega Christopher E. Niemczak Brian P. Jackson Margaret R. Karagas Jay C. Buckey |
| author_facet | Enica R. Massawe Ndeserua Moshi Junkun Ren Catherine C. Rieke Albert K. Magohe Abigail M. Fellows Enat A. Arega Christopher E. Niemczak Brian P. Jackson Margaret R. Karagas Jay C. Buckey |
| author_sort | Enica R. Massawe |
| collection | DOAJ |
| description | # Background
A unique syndrome affecting young adults of unexplained hearing loss often associated with uncorrectable poor visual acuity and lower extremity numbness is endemic in Dar es Salaam. This study characterised the hearing loss, associated it with other symptoms, and gathered information on potential causes.
# Methods
Forty-seven patients (23 men, 24 women) \<40 years old with a symptom consistent with the syndrome, negative syphilis test, and no head injury history were recruited from Muhimbili National Hospital. 18 controls (10 men, 8 women) were recruited from the same neighborhoods as patients. Hearing ability and cochlear outer hair cell function (distortion-product otoacoustic emissions (DPOAEs)) were assessed, as were visual acuity and colour vision. Peripheral neuropathy was evaluated using the Michigan Neuropathy Screening Instrument (MNSI), and physical examination. Blood C-reactive protein levels and toenail trace metal concentrations were measured. Environmental exposures were elicited using a questionnaire. Patients with at least two of the following signs were defined as having the syndrome: poor hearing with normal DPOAEs, vision not correctable to better than 20/30, or a MNSI score greater than 4.
# Results
29 participants met the case definition. C-reactive protein (CRP) levels did not differ between groups but manganese, cobalt and tin levels were each greater in the cases than controls. No other environmental exposure differences were noted.
# Conclusions
Toenail manganese, cobalt, and tin levels were higher in those with the syndrome. These metals are potential neurotoxins suggesting a possible environmental origin for this unique and debilitating syndrome. |
| format | Article |
| id | doaj-art-2e5c27eda038476c95a79aa041ca2579 |
| institution | DOAJ |
| issn | 2399-1623 |
| language | English |
| publishDate | 2021-03-01 |
| publisher | Inishmore Laser Scientific Publishing Ltd |
| record_format | Article |
| series | Journal of Global Health Reports |
| spelling | doaj-art-2e5c27eda038476c95a79aa041ca25792025-08-20T03:20:46ZengInishmore Laser Scientific Publishing LtdJournal of Global Health Reports2399-16232021-03-01510.29392/001c.21360Unexplained multi-sensory neuropathy syndrome in young Tanzanian adultsEnica R. MassaweNdeserua MoshiJunkun RenCatherine C. RiekeAlbert K. MagoheAbigail M. FellowsEnat A. AregaChristopher E. NiemczakBrian P. JacksonMargaret R. KaragasJay C. Buckey# Background A unique syndrome affecting young adults of unexplained hearing loss often associated with uncorrectable poor visual acuity and lower extremity numbness is endemic in Dar es Salaam. This study characterised the hearing loss, associated it with other symptoms, and gathered information on potential causes. # Methods Forty-seven patients (23 men, 24 women) \<40 years old with a symptom consistent with the syndrome, negative syphilis test, and no head injury history were recruited from Muhimbili National Hospital. 18 controls (10 men, 8 women) were recruited from the same neighborhoods as patients. Hearing ability and cochlear outer hair cell function (distortion-product otoacoustic emissions (DPOAEs)) were assessed, as were visual acuity and colour vision. Peripheral neuropathy was evaluated using the Michigan Neuropathy Screening Instrument (MNSI), and physical examination. Blood C-reactive protein levels and toenail trace metal concentrations were measured. Environmental exposures were elicited using a questionnaire. Patients with at least two of the following signs were defined as having the syndrome: poor hearing with normal DPOAEs, vision not correctable to better than 20/30, or a MNSI score greater than 4. # Results 29 participants met the case definition. C-reactive protein (CRP) levels did not differ between groups but manganese, cobalt and tin levels were each greater in the cases than controls. No other environmental exposure differences were noted. # Conclusions Toenail manganese, cobalt, and tin levels were higher in those with the syndrome. These metals are potential neurotoxins suggesting a possible environmental origin for this unique and debilitating syndrome.https://doi.org/10.29392/001c.21360 |
| spellingShingle | Enica R. Massawe Ndeserua Moshi Junkun Ren Catherine C. Rieke Albert K. Magohe Abigail M. Fellows Enat A. Arega Christopher E. Niemczak Brian P. Jackson Margaret R. Karagas Jay C. Buckey Unexplained multi-sensory neuropathy syndrome in young Tanzanian adults Journal of Global Health Reports |
| title | Unexplained multi-sensory neuropathy syndrome in young Tanzanian adults |
| title_full | Unexplained multi-sensory neuropathy syndrome in young Tanzanian adults |
| title_fullStr | Unexplained multi-sensory neuropathy syndrome in young Tanzanian adults |
| title_full_unstemmed | Unexplained multi-sensory neuropathy syndrome in young Tanzanian adults |
| title_short | Unexplained multi-sensory neuropathy syndrome in young Tanzanian adults |
| title_sort | unexplained multi sensory neuropathy syndrome in young tanzanian adults |
| url | https://doi.org/10.29392/001c.21360 |
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