Cobalamin Deficiency: Clinical Picture and Radiological Findings

被引:208
作者
Briani, Chiara [1 ]
Dalla Torre, Chiara [1 ]
Citton, Valentina [2 ]
Manara, Renzo [2 ,3 ]
Pompanin, Sara [1 ]
Binotto, Gianni [4 ]
Adami, Fausto [4 ]
机构
[1] Univ Padua, Dept Neurosci Neurol Psychiat Sensorial Reconstru, I-35128 Padua, Italy
[2] IRCCS San Camillo, I-30011 Venice, Italy
[3] Univ Salerno, I-84081 Baronissi, Italy
[4] Univ Padua, Dept Med, Hematol Unit, I-35128 Padua, Italy
关键词
vitamin B12; cobalamin; neuropathy; subacute combined degeneration; neuroimaging; SUBACUTE COMBINED DEGENERATION; VITAMIN-B-12; DEFICIENCY; SPINAL-CORD; DEMENTIA; MRI; HOMOCYSTEINE; FOLATE; DEPRESSION; ACID; B-12;
D O I
10.3390/nu5114521
中图分类号
R15 [营养卫生、食品卫生]; TS201 [基础科学];
学科分类号
100403 ;
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.
引用
收藏
页码:4521 / 4539
页数:19
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