Hypothalamic digoxin and hypomagnesemia in human pre-eclampsic toxemia, cortical venous thrombosis, and postpartum psychosis

The isoprenoid pathway produces three key metabolites—digoxin (membrane sodium-potassium ATPase inhibitor and regulator of neurotransmitter transport), dolichol (regulates N-glycosylation of proteins), and ubiquinone (free radical scavenger). The pathway was assessed in patients with pre-eclampsic toxaemia, cortical venous thrombosis, and postpartum psychosis. It was also studied for comparison in patients with right hemispheric, left hemispheric, and bihemispheric dominance. The results of the study showed that the isoprenoid pathway was upregulated with increased digoxin synthesis in all the three groups of patients. There was also a reduction in red blood cell (RBC) membrane Na+–K+ ATPase activity and serum magnesium levels. There was an increase in serum tryptophan catabolites and reduction in tyrosine catabolites. The serum dolichol and glycoconjugate levels were increased and lysosomal stability reduced with increased plasma lysosomal enzymes in all the three groups. The serum ubiquinone levels were low, and RBC free radical parameters increased. The RBC membrane cholesterol: phospholipid ratio was increased, and glycoconjugate was reduced in the membrane of these patients. This pattern correlated with those in right hemispheric dominance. The isoprenoid pathway and hypothalamic digoxin may thus play a crucial role in the pathogenesis of CVT, PET, and postpartum psychosis. J. Trace Elem. Exp. Med. 15:171–190 2002. © 2002 Wiley-Liss, Inc.