Subacute combined spinal cord degeneration and pancytopenia secondary to severe vitamin B12 deficiency
Palavras-chave:
Vitamin B 12 deficiency, Subacute combined degeneration, Pancytopenia, Digestive system abnormalities, Nervous system diseasesResumo
CONTEXT: Decreased vitamin B12 concentration does not usually result in clinical or hematological abnormalities. Subacute combined spinal cord degeneration and pancytopenia are two serious and rarely displayed consequences that appear in severe deficits. CASE REPORT: We present the case of a patient with subacute combined spinal cord degeneration and pancytopenia secondary to severe and sustained vitamin B12 deficiency. Such cases are rare nowadays and have potentially fatal consequences. CONCLUSIONS: Vitamin B12 deficiency should be taken into consideration in the differential diagnosis in cases of blood disorders or severe neurological symptoms. Early diagnosis and treatment can avoid irreversible consequences.
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Lindenbaum J, Healton EB, Savage DG, et al. Neuropsychiatric disorders caused by cobalamin deficiency in the absence of anemia or macrocytosis. N Engl J Med. 1988;318(26):1720-8.
So YT, Simon RP. Deficiency diseases of the nervous system. In: Bradley WG, Daroff RB, Fenichel GM, Marsden CD, editors. Neurology in clinical practice. 3rd ed. Boston: Butterworth-Heinemann; 2000. p. 1495-9.
Galve Gorriz MP. Degeneración neuromuscular. Available from: http://www.unizar.es/med_naturista/Tratamientos/nervioso/Degeneracio%20Neuromuscular.pdf. Accessed in 2011 (Jun 28).
Playas Pérez G, Orozco Paredes J, López Ruiz M, et al. Degeneración combinada subaguda de la médula espinal por deficiencia de vitamina B12. Revista Medica del Hospital General de Mexico. 2002;65(2):88-
Available from: http://www.imbiomed.com.mx/1/1/articulos.php?method=showDetail&id_articulo=2879&id_seccion=332&id_ejemplar=327&id_revista=29. Accessed in 2011 (Jun 28).
Vidal-Alaball J, Butler CC, Cannings-John R, et al. Oral vitamin B12 versus intramuscular vitamin B12 for vitamin B12 deficiency. Cochrane Database Syst Rev. 2005;(3):CD004655.
Manuel Porcel J. Tratamiento oral con cobalamina en la anemia megaloblástica [Oral treatment of megaloblastic anemia with cobalamin]. Med Clin (Barc). 2006;127(20):796.
Hemmer B, Glocker FX, Schumacher M, Deuschl G, Lücking CH. Subacute combined degeneration: clinical, electrophysiological, and magnetic resonance imaging findings. J Neurol Neurosurg Psychiatry. 1998;65(6):822-7.
González-Tarrío L, Fontana M, Romero J. Degeneración combinada subaguda medular, una complicación infrecuente de un problema frecuente en la práctica clínica: el déficit de vitamina B12. SEMERGEN Medicina de Familia. 2008;34(8):417-9. Available from: http://apps.elsevier.es/watermark/ctl_servlet?_f=10&pident_articulo=13127222&pident_usuario=0&pcontactid=&pident_revista=40&ty=65&accion=L&origen=elsevier&web=www.elsevier.es&lan=es&fichero=40v34n08a13127222pdf001.pdf. Accessed in 2011 (Jun 28).
Ishiko T, Taguchi T, Takeguchi M, Saito H, Nanri K. [Case of Wernicke’s encephalopathy and subacute combined degeneration of the spinal cord due to vitamin deficiency showing changes in the bilateral corpus striatum and cardiac arrest due to beriberi heart disease]. Brain Nerve. 2009;61(9):1069-73.
Zara G, Grassivaro F, Brocadello F, Manara R, Pesenti FF. Case of sensory ataxic ganglionopathy-myelopathy in copper deficiency. J Neurol Sci. 2009;277(1-2):184-6.
Nagaishi A, Takashima H, Fukuda Y, Kuroda Y. [A case of subacute combined degeneration with normal serum vitamin B12 level]. Rinsho Shinkeigaku. 2003;43(9):552-5.
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Este trabalho está licenciado sob uma licença Creative Commons Attribution 4.0 International License.
