Bhaskar Hemlata, Chaudhary Rekha
Department of Medicine, The University of Toledo, 3000 Arlington Avenue Toledo, OH 43614, USA.
Case Rep Med. 2010;2010:691563. doi: 10.1155/2010/691563. Epub 2011 Feb 27.
Background. Vitamin B12 is vital for optimal functioning of various organ systems but more importantly the central nervous system and the hematological system. Deficiency of vitamin B12 clinically manifests as excessive daytime fatigue, memory difficulties, encephalopathy, myelopathy, peripheral neuropathy, and optic neuropathy. In occupational medicine, vitamin B12 deficiency has been reported with exposure to nitrous oxide in health care workers. However, not much is known about exposure to Freons in other industries and vitamin B12 deficiency. Aim. We are reporting a case of vitamin B12 deficiency in the setting of exposure to chlorofluorocarbon (CFC) gases. Case Report. A 55-year-old male refrigerator mechanic experienced recurrent visual symptoms, which included diplopia and blurring. A complete workup was done and was significant of vitamin B12 deficiency. However, his B12 levels were refractory to supplementation. Appropriate precautions at workplace improved patient's symptoms and were associated with significant improvement in B12 levels. Conclusion. To the best of our knowledge, this is the first reported case of vitamin B12 deficiency (that remains refractory to supplementation) in the setting of exposure to Freon gases.
背景。维生素B12对于各种器官系统的最佳功能至关重要，但更重要的是对中枢神经系统和血液系统。维生素B12缺乏在临床上表现为白天过度疲劳、记忆困难、脑病、脊髓病、周围神经病变和视神经病变。在职业医学中，已报道医护人员因接触氧化亚氮而出现维生素B12缺乏。然而，对于其他行业接触氟利昂与维生素B12缺乏的情况了解不多。目的。我们报告一例在接触氯氟烃（CFC）气体情况下发生维生素B12缺乏的病例。病例报告。一名55岁的男性冰箱修理工出现反复的视觉症状，包括复视和视力模糊。进行了全面检查，结果显示存在维生素B12缺乏。然而，他的维生素B12水平对补充治疗无效。在工作场所采取适当的预防措施改善了患者的症状，并使维生素B12水平显著提高。结论。据我们所知，这是首例报道的在接触氟利昂气体情况下发生的维生素B12缺乏（对补充治疗无效）病例。
