Department of Neurology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Nutrition. 2012 Jul;28(7-8):821-4. doi: 10.1016/j.nut.2011.11.022. Epub 2012 Mar 28.
To elucidate the significance of folate deficiency in alcoholic and nutritional neuropathies.
We preformed a comprehensive clinical screening of a patient with chronic alcoholism who manifested neuropathy, macrocytic anemia, liver dysfunction, and folate deficiency.
A 33-y-old woman with chronic alcoholism presented with acutely progressive glove- and stocking-type sensorimotor polyneuropathy. Although an episode of neuropathy preceded the current episode by 2 y, its cause was never determined. The findings of nerve conduction studies were indicative of axonal neuropathy. Laboratory findings revealed macrocytic anemia and liver dysfunction. Her serum level of folate was reduced, whereas thiamine, riboflavin, and cobalamin levels were within normal range. The neuropathy and anemia showed gradual recovery after the initiation of folic acid supplementation.
This case study indicates that folate deficiency should be monitored closely in patients with chronic alcoholism and associated malnutrition. Additionally, folate deficiency should be considered as a differential diagnosis of neuropathy.
阐明叶酸缺乏在酒精性和营养性神经病中的意义。
我们对一名患有慢性酒精中毒并表现出神经病、巨幼细胞性贫血、肝功能障碍和叶酸缺乏的患者进行了全面的临床筛查。
一名 33 岁的慢性酒精中毒女性患者出现急性进行性手套和袜子样感觉运动多发性神经病。尽管神经病变的发作比当前发作提前了 2 年，但从未确定其原因。神经传导研究的结果提示轴索性神经病。实验室检查发现巨幼细胞性贫血和肝功能障碍。她的血清叶酸水平降低，而硫胺素、核黄素和钴胺素水平正常。在开始补充叶酸后，神经病和贫血逐渐恢复。
本病例研究表明，应密切监测慢性酒精中毒和相关营养不良患者的叶酸缺乏情况。此外，应将叶酸缺乏症作为神经病的鉴别诊断之一。
