Three Case Reports to Illustrate Clinical Applications in the Use of Erythrocyte Transketolase
J.S. was a 77-year-old woman. In June 2005, she came to our clinic complaining of extreme fatigue. This was severe enough to cause her to go to sleep briefly while driving. She was also experiencing occasional ‘dizziness’ on rising in the morning and severe constipation. She reported that an ophthalmologist had found increased pressure in one eye and she was using eye drops prescribed for this. Past history revealed that she had received radioactive iodine as a child and was being treated with synthetic T3. Although the TKA was in the normal range () the TPPE was 18%, indicating a mild degree of thiamin deficiency.\nShe was treated with orally administered nutritional supplements that included a multivitamin, 3 g of ascorbic acid (bowel tolerance), 300 mg of magnesium/potassium/aspartate, 250 mg of calcium with 166 mg magnesium in a combination tablet taken at bedtime, 5 mg of phytonadione (vitamin K1) because of a history of osteoporosis diagnosed elsewhere, 200 mg of lipoic acid and 150 mg of TTFD.\nTwo months later she reported that she had ‘more energy’. In spite of this the TKA was lower in concentration and the TPPE had accelerated dramatically (). Although there was no exacerbation of symptoms, 1 month later the laboratory results had deteriorated again and it was decided to provide her with a series of intravenous infusions (). Following this treatment, the laboratory test was repeated. The TKA had increased its activity and the TPPE had fallen to 3% ()