Reynolds E H, Linnell J C, Faludy J E
Department of Neurology, King's College Hospital, London, England.
Arch Neurol. 1991 Aug;48(8):808-11. doi: 10.1001/archneur.1991.00530200044017.
We describe 10 patients with a previously unreported, to our knowledge, association of multiple sclerosis and unusual vitamin B12 deficiency. The clinical features and the age at presentation were typical of multiple sclerosis, with eight cases occurring before age 40 years, which is a rare age for vitamin B12 deficiency. Nine patients had hematologic abnormalities, but only two were anemic. All six patients examined had low erythrocyte cobalamin levels. Only two patients had pernicious anemia; in the remaining patients the vitamin B12 deficiency was unexplained. A vitamin B12 binding and/or transport is suspected. The nature of the association of multiple sclerosis and vitamin B12 deficiency is unclear but is likely to be more than coincidental. Further studies of vitamin B12 metabolism, binding, and transport in multiple sclerosis are indicated, as these cases may offer a clue to the understanding of a still mysterious neurologic disorder.
据我们所知，我们描述了10例患有此前未报道过的多发性硬化症与异常维生素B12缺乏症关联的患者。临床特征和发病年龄符合多发性硬化症的典型表现，其中8例发生在40岁之前，这对于维生素B12缺乏症来说是罕见的发病年龄。9例患者有血液学异常，但仅有2例贫血。接受检查的6例患者红细胞钴胺素水平均较低。仅有2例患者患有恶性贫血；其余患者的维生素B12缺乏原因不明。怀疑存在维生素B12结合和/或转运异常。多发性硬化症与维生素B12缺乏症之间关联的性质尚不清楚，但可能并非巧合。鉴于这些病例可能为理解这一仍很神秘的神经系统疾病提供线索，有必要对多发性硬化症患者的维生素B12代谢、结合和转运进行进一步研究。
