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In South Africa, however, a prevalence of 3 in 1,000 individuals has been estimated, most of the cases arising in Whites of Dutch ancestry Acute attacks can be triggered or worsened by a number of factors including: Some medications Alcohol and drugs Dieting or fasting Infections Hormone fluctuations related to the menstrual cycle Acute Attack Symptoms Acute attacks can include a wide array of symptoms

Given the prevalence of folate depletion in patients with cancer 95,96,97 , controlled dietary histidine supplementation merits further investigation, stratifying on gut dysbiosis, as an adjunct to immunotherapy in patients with first-line stage III or IV cancer, particularly in older patients or as an interceptive measure to prevent or delay cancer incidence in individuals at high cancer risk

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