Cobalamin Deficiency: Clinical Picture and Radiological Findings

Nutrients

Chiara Briani³  Chiara Dalla Torre³  Valentina Citton¹  Renzo Manara¹  Sara Pompanin³  Gianni Binotto² 

[1] IRCCS San Camillo, Venezia 30011 Italy; E-Mails:;Department of Medicine, Hematology Unit, University of Padova, Padova 35128, Italy; E-Mails:;Department of Neurosciences, Neurological, Psychiatric, Sensorial, Reconstructive and Rehabilitative Sciences, University of Padova, Via Giustiniani 5, Padova 35128, Italy; E-Mails:

关键词: vitamin B12;    cobalamin;    neuropathy;    subacute combined degeneration;    neuroimaging;   

DOI  :  10.3390/nu5114521

来源: mdpi

【 摘 要 】

Vitamin B12 deficiency causes a wide range of hematological, gastrointestinal, psychiatric and neurological disorders. Hematological presentation of cobalamin deficiency ranges from the incidental increase of mean corpuscular volume and neutrophil hypersegmentation to symptoms due to severe anemia, such as angor, dyspnea on exertion, fatigue or symptoms related to congestive heart failure, such as ankle edema, orthopnea and nocturia. Neuropsychiatric symptoms may precede hematologic signs and are represented by myelopathy, neuropathy, dementia and, less often, optic nerve atrophy. The spinal cord manifestation, subacute combined degeneration (SCD), is characterized by symmetric dysesthesia, disturbance of position sense and spastic paraparesis or tetraparesis. The most consistent MRI finding is a symmetrical abnormally increased T2 signal intensity confined to posterior or posterior and lateral columns in the cervical and thoracic spinal cord. Isolated peripheral neuropathy is less frequent, but likely overlooked. Vitamin B12 deficiency has been correlated negatively with cognitive functioning in healthy elderly subjects. Symptoms include slow mentation, memory impairment, attention deficits and dementia. Optic neuropathy occurs occasionally in adult patient. It is characterized by symmetric, painless and progressive visual loss. Parenteral replacement therapy should be started soon after the vitamin deficiency has been established.

【 授权许可】

CC BY   
© 2013 by the authors; licensee MDPI, Basel, Switzerland.