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The pathogen Aa can secret leukotoxin A and form pores in the neutrophil membranes that lead to neutrophil hyper citrullination, which results in the release of citrullinated autoantigens in the gums

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Adequate Protein Intake Target: 1.6-2.2 grams of protein per kilogram of body weight per day 4 For most people, this translates to: 150 lb person: 110-150g protein/day 200 lb person: 145-200g protein/day 250 lb person: 180-250g protein/day This is significantly higher than standard recommendations (0.8g/kg) because during caloric restriction, your protein needs increase to: Prevent muscle protein breakdown Support muscle protein synthesis Maintain metabolic function Support satiety and appetite regulation 2

Discussion We present a rare case of spontaneous bilateral BGH which likely occurred in the right basal ganglia and distributed to the contralateral basal ganglia across the anterior commissure via the Canal of Gratiolet