Wellmer J, Sturm K-U, Herrmann W, Hoever J, Klockgether T, Linnebank M
Klinik und Poliklinik für Neurologie, Universitätsklinikum Bonn.
Nervenarzt. 2006 Oct;77(10):1228-31. doi: 10.1007/s00115-006-2137-4.
Vitamin B12 deficiency due to malnutrition or malabsorption may lead to pernicious anemia and neurological disorders. Although randomized prospective studies have shown that pernicious anemia can be safely treated with oral vitamin B12 even in the absence of intrinsic factor, it is still common practice to treat patients with neurological symptoms with intramuscular cyancobalamin injections. We report the successful oral treatment of subacute combined degeneration of the spinal cord in a 24-year-old woman closely monitored clinically with MRI and plasma levels of vitamin B12, homocysteine, and methylmalonic acid. We suggest monitored oral substitution therapy as first-line therapy for neurological disorders related to vitamin B12 deficiency.
由于营养不良或吸收不良导致的维生素B12缺乏可能会引发恶性贫血和神经系统疾病。尽管随机前瞻性研究表明，即使缺乏内因子，口服维生素B12也可安全地治疗恶性贫血，但对于有神经症状的患者，肌肉注射氰钴胺素仍是常用的治疗方法。我们报告了一名24岁女性脊髓亚急性联合变性的成功口服治疗案例，该患者通过MRI以及维生素B12、同型半胱氨酸和甲基丙二酸的血浆水平进行临床密切监测。我们建议将监测下的口服替代疗法作为与维生素B12缺乏相关的神经系统疾病的一线治疗方法。
