| An elderly man was diagnosed with celiac disease, which presented with three notable features: first, presentation at the age of 70 with no prior gastrointestinal symptomatology or positive family history; second, triggering of all symptoms following recent myocardial infarction and infective endocarditis; third, presentation with marked (more than 20 percent) weight loss and pellagra-like skin lesions despite nearly normal examination and laboratory tests. Thus, celiac disease may present as a pellagra-like syndrome in the elderly with predominant weight loss that is enhanced by the related taste disturbances. ( info) |
2/54. Persistent impairment of taste associated with terbinafine. A second case of persistent taste disturbance associated with terbinafine is described. Taste disturbance associated with this drug is reviewed and a table is provided listing the more common drugs associated with taste disturbance. ( info) |
| acromegaly is an uncommon condition, with an annual incidence in the UK of three per million. The gradual onset of the clinical features mean that often friends and relatives are unaware of the underlying pathology. In view of the morbidity, and indeed mortality, arising from undiagnosed cases, general dental practitioners and other healthcare workers should routinely take note of systemic as well as intra-oral changes occurring in their patients when seen on review. The association of paraesthesia, anaesthesia and pain with acromegaly is well documented. However, there appear to be few reports linking acromegaly with orofacial pain or dysaesthesia. This paper describes two such cases. ( info) |
4/54. Alterations in taste sensation: a case presentation of a patient with end-stage pancreatic cancer. Alterations in taste can occur as a result of cancer, cancer treatment, and from a variety of other causes. Cancer patients frequently experience taste alterations, which often go undetected in the clinical setting. This case presentation depicts a 90-year-old client with end-stage pancreatic cancer undergoing chemotherapy treatment with gemcitabine. The symptomatology of taste changes is described. Etiology and rationale for taste changes is presented for the cancer patient population, and for the general population. review of the cancer literature, research instruments, and goals/outcomes are discussed. The author determined that interventional studies are lacking, and research is needed. ( info) |
5/54. Terbinafine-associated taste disturbance with normal taste threshold scores. The medical literature reveals numerous reports of transient taste disturbance associated with the use of oral terbinafine. A review of these reports, however, fails to confirm taste disturbances by formal taste testing. In this article, a case of long-standing taste dysfunction in a patient who exhibited normal formal taste thresholds is described. ( info) |
6/54. Posttraumatic anosmia in craniofacial trauma. Although the clinical implications of anosmia can be significant, posttraumatic anosmia is generally given relatively little attention in the clinical setting. patients who sustain craniofacial trauma are most at risk. The incidence of posttraumatic anosmia varies according to the severity of injury and has an overall estimated incidence of 7%. Factors that increase the risk of developing anosmia include anterior skull base fractures, bilateral subfrontal lobe injury, dural lacerations, and cerebrospinal fluid leakage. recovery of function has been estimated to be approximately 10%. time of recovery, if it occurs, varies between 8 weeks and 2 years. Presented herein are the clinical, radiographic, pathophysiologic, and anatomic substrata of posttraumatic anosmia. ( info) |
7/54. Severe gustatory disorder caused by cisplatin and etoposide. A 48-year-old woman with small-cell lung cancer received combined chemotherapy consisting of cisplatin (CDDP) and etoposide (Vp-16). Although the gustatory threshold in the glossopharyngeal nerve area was normal (14 dB) before chemotherapy, it rose to 22 dB on day 8 of chemotherapy, and it could not be measured, because of severe gustatory disorder, from day 15 to day 29. In the chorda tympani nerve area, the threshold was normal until day 15, but it could not be measured on day 29. This gustatory disorder continued for 2 more months, until the time of the patient's discharge. Although gustatory disorder caused by anticancer drugs has been reported as a rare side effect, this may be because it has been reported as appetite loss, and it may happen more frequently than reported cases would suggest. As gustatory disorder reduces the patient's quality of life, the presence of this side effect should be given more serious consideration. ( info) |
8/54. Secretory function of the salivary gland in patients with taste disorders or xerostomia: correlation with zinc deficiency. A notable proportion of patients with taste disorders complain of xerostomia and when zinc is prescribed the xerostomia is often improved in conjunction with the taste disorder. To study the relationship between taste disorders, zinc deficiency and xerostomia, we measured salivary gland function and zinc levels in 93 patients with hypogeusia and/or xerostomia and 60 patients with unilateral acute peripheral facial palsy who served as controls. We then prescribed zinc for patients with low serum zinc levels and evaluated xerostomia and taste sensation after 6 months of this treatment. The salivary gland secretory ratio (SGSR), determined by dynamic salivary 99mTc scintigraphy, was found to be an objective measure of salivary gland function and was reduced in patients with xerostomia. patients with salivary gland dysfunction also had abnormal morphology of the papillae of the tongue. No significant relation was found between the severity of taste disorders and SGSR values, but low SGSR values were found in patients with zinc deficiency. patients with taste disorders and/or xerostomia who were treated with zinc had relief of symptoms at 6 months, indicating that both taste disorders and xerostomia are among the symptoms of zinc deficiency. ( info) |
9/54. Changes in gustatory sense during pregnancy. Changes in gustatory sense were investigated in 97 pregnant women and in 30 healthy, non-pregnant women who served as controls. All 97 pregnant women completed a questionnaire regarding taste changes and 32 of them underwent serial tests of gustatory function, including electrogustometry and testing with filter paper disks placed over the areas of the chorda tympani nerve and glossopharyngeal nerve. All gustatory testing was performed by the same person. In addition, serum levels of trace elements were measured in 72 of the pregnant women. Of the 97 pregnant women, 90 (92.8%) reported in the questionnaire that they had experienced some type of change in taste during pregnancy, usually a change in sour taste (59 women; 65.6%). pregnant women had higher gustatory thresholds than non-pregnant women, with an especially marked decrease in gustatory function being noticed in the first trimester. Although serum zinc levels decreased in pregnant women between the second and third trimesters, zinc levels were in the normal range in the early stage of pregnancy. Thus, it is difficult to explain dysgeusia in the early stage of pregnancy as being associated with a deficiency of zinc. The decrease in gustatory function during the first trimester is considered to be due to the notable changes in secretion of hormones that occur during this stage. ( info) |
10/54. A case of Cronkhite-canada syndrome whose major complaint, taste disturbance, was improved by zinc therapy. A patient whose major complaint was taste disturbance and who was diagnosed as having Cronkhite-canada syndrome was prescribed zinc sulfate. Improvement in taste disturbance was noted after 3 weeks of treatment, followed by gradual improvement in skin and gastrointestinal symptoms. Cronkhite-canada syndrome can be considered a zinc-deficiency disorder caused by gastrointestinal polyposis. ( info) |