CASE REPORT OF TUBEROUS SCLEROSIS IN PATIENT PRESENTED WITH VASAMOL CONSUMPTION

Tuberous sclerosis complex (TSC) is a rare genetic neurocutaneous syndrome characterized by glial tumors in the brain and retina, fibromas in various organs, and a classic triad of epilepsy, intellectual disability, and adenoma sebaceum. However, nearly 50% of affected individuals have normal intelligence, and 15% do not experience seizures. Neurological symptoms typically appear in childhood, while skin manifestations often emerge later. We present the case of a 31 year-old woman diagnosed with TSC, who initially sought medical attention for vasamol consumption. The patient developed rhabdomyolysis, acute fulminant hepatitis, and acute kidney injury (AKI) following the ingestion. Her hepatitis was managed with N-acetylcysteine infusion, steroids, and glutathione. Due to worsening renal function, she underwent two dialysis sessions. On examination, multiple small, yellow papules consistent with adenoma sebaceum were noted on her face and neck. She also had hypopigmented ash-leaf macules, confetti lesions on her arms and legs, and shagreen patches on her back, which she had since childhood. The patient had no history of seizures or neurological symptoms, and a significant family history of TSC was noted. Brain MRI revealed cortical tubers, and ultrasonography showed a hyperechoic renal angiomyolipoma in her left kidney. Despite the absence of typical neurological symptoms, the clinical and radiological findings led to the diagnosis of TSC.