Leber hereditary optic neuropathy aociated with ue of ephedra alkaloid

Purpoe We report a cae of Leber hereditary optic neuropathy in a patient who wa uing ephedra alkaloid at the time of onet of hi optic neuropathy. Deign Obervational cae report. Method Bilateral, painle, progreive lo of viion developed in a 30-year-old man. He reported a one pack-per day, 10-year hitory of tobacco ue and drinking 18 to 24 can of beer per day a well a the ue of a dietary upplement containing ephedra and caffeine before the onet of viion lo. Reult We report the bilateral, progreive, painle lo of viion in a patient with bilateral cecocentral cotoma and optic nerve pallor. Mitochondrial DNA teting confirmed a Leber hereditary optic neuropathy mutation ite at loci 11778. Concluion We propoe that our patient’ ue of a dietary upplement containing ephedra alkaloid played an additive role to hi tobacco and alcohol ue in cauing tre to the already abnormal mitochondrial function, and thereby contributed to the onet of hi optic neuropathy. We recommend that patient and familie with known Leber hereditary optic neuropathy hould be aked about the ue of over-the-counter drug or upplement, and it may be prudent to advie patient againt uing uch dietary upplement.