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[Diagnosis of vitamin B12 deficiency: a case illustrating diagnostic pitfalls].
Rev Neurol (Paris). 2010 Feb; 166(2):242-7.RN

Abstract

INTRODUCTION

Vitamin B12 deficiency is a longstanding public health problem which affects more than 20% of the elderly population. Among multiple causes of vitamin B12 deficiency, Biermer's disease is currently mentioned in about 25% of the cases.

OBSERVATION

We report the case of a 71-year-old woman, taking folate substitution therapy who, over 2 years, progressively developed spinal combined sclerosis, subacute dementia and severe neuropathy leading to a bedridden state. The initial assessment revealed normocytic anemia, without vitamin B12 deficiency and without increased plasma level of biological markers. The plasma folate level was high. Vitamin B12 assay was repeated leading to the diagnosis of deficiency associated with the presence of intrinsic factor antibodies.

DISCUSSION

This observation illustrates the broad spectrum of clinical presentations of vitamin B12 deficiency. In the present case, the lack of sensitivity of biological markers delayed diagnosis and had a dramatic impact on outcome. This case highlights the importance of promoting factors such as isolated folate substitution in B12 deficient patients.

Links

Publisher Full Text
linkinghub.elsevier.com
em-consulte.com

Authors+Show Affiliations

Gutierrez M
Centre de référence des maladies neuromusculaires et de la SLA, hôpital de La Timone, 264, rue Saint-Pierre, 13385 Marseille cedex 20, France. gutierrezmariana4@gmail.com
Franques J
No affiliation info available
Faivre A
No affiliation info available
Koric L
No affiliation info available
Chiche L
No affiliation info available
Attarian S
No affiliation info available
Pouget J
No affiliation info available

MeSH

AgedAnemiaBedsBrainDementiaDiagnosis, DifferentialFemaleFolic AcidFunctional LateralityHumansMagnetic Resonance ImagingMotor ActivitySclerosisVitamin B 12Vitamin B 12 Deficiency

Pub Type(s)

Case Reports
English Abstract
Journal Article

Language

fre

PubMed ID

19520408

Citation

Gutierrez, M, et al. "[Diagnosis of Vitamin B12 Deficiency: a Case Illustrating Diagnostic Pitfalls]." Revue Neurologique, vol. 166, no. 2, 2010, pp. 242-7.
Gutierrez M, Franques J, Faivre A, et al. [Diagnosis of vitamin B12 deficiency: a case illustrating diagnostic pitfalls]. Rev Neurol (Paris). 2010;166(2):242-7.
Gutierrez, M., Franques, J., Faivre, A., Koric, L., Chiche, L., Attarian, S., & Pouget, J. (2010). [Diagnosis of vitamin B12 deficiency: a case illustrating diagnostic pitfalls]. Revue Neurologique, 166(2), 242-7. https://doi.org/10.1016/j.neurol.2009.05.002
Gutierrez M, et al. [Diagnosis of Vitamin B12 Deficiency: a Case Illustrating Diagnostic Pitfalls]. Rev Neurol (Paris). 2010;166(2):242-7. PubMed PMID: 19520408.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Diagnosis of vitamin B12 deficiency: a case illustrating diagnostic pitfalls]. AU - Gutierrez,M, AU - Franques,J, AU - Faivre,A, AU - Koric,L, AU - Chiche,L, AU - Attarian,S, AU - Pouget,J, Y1 - 2009/06/10/ PY - 2009/01/08/received PY - 2009/03/26/revised PY - 2009/05/12/accepted PY - 2009/6/13/entrez PY - 2009/6/13/pubmed PY - 2010/5/1/medline SP - 242 EP - 7 JF - Revue neurologique JO - Rev Neurol (Paris) VL - 166 IS - 2 N2 - INTRODUCTION: Vitamin B12 deficiency is a longstanding public health problem which affects more than 20% of the elderly population. Among multiple causes of vitamin B12 deficiency, Biermer's disease is currently mentioned in about 25% of the cases. OBSERVATION: We report the case of a 71-year-old woman, taking folate substitution therapy who, over 2 years, progressively developed spinal combined sclerosis, subacute dementia and severe neuropathy leading to a bedridden state. The initial assessment revealed normocytic anemia, without vitamin B12 deficiency and without increased plasma level of biological markers. The plasma folate level was high. Vitamin B12 assay was repeated leading to the diagnosis of deficiency associated with the presence of intrinsic factor antibodies. DISCUSSION: This observation illustrates the broad spectrum of clinical presentations of vitamin B12 deficiency. In the present case, the lack of sensitivity of biological markers delayed diagnosis and had a dramatic impact on outcome. This case highlights the importance of promoting factors such as isolated folate substitution in B12 deficient patients. SN - 0035-3787 UR - https://www.unboundmedicine.com/medline/citation/19520408/[Diagnosis_of_vitamin_B12_deficiency:_a_case_illustrating_diagnostic_pitfalls]_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0035-3787(09)00267-7 DB - PRIME DP - Unbound Medicine ER -