Agrawala Ritesh Kumar, Sahoo Srikanta Kumar, Choudhury Arun Kumar, Mohanty Binoy Kumar, Baliarsinha Anoj Kumar
Department of Endocrinology, Sriram Chandra Bhanj Medical College and Hospital, Cuttack, Odisha, India.
Indian J Endocrinol Metab. 2013 Oct;17(Suppl 1):S254-6. doi: 10.4103/2230-8210.119591.
A 35-year-female presented with generalized weakness, weight loss, and progressive pigmentation was worked up for suspicion of Addisons disease. On examination hyper pigmentation was noted on both palmar and dorsal aspect of hands involving knuckles, creases, feet, tongue, oral mucosa and gluteal region. There was no evidence of hypocortisolemia as initially suspected, and literature search revealed a possibility of vitamin B12 deficiency. She had megaloblastic anemia with a low serum vitamin B12, mostly due to poor dietary intake. Her hyper pigmentation resolved with vitamin B12 supplementation. Skin biopsy showed increased pigmentation at stratum spinosum and basal-layer. The mechanism of hyper pigmentation in vitamin B12 deficiency was due to an increase in melanin synthesis.
一名35岁女性因全身无力、体重减轻和进行性色素沉着就诊，怀疑患有艾迪生病而接受检查。检查发现双手掌面和背面包括指关节、褶皱处、足部、舌头、口腔黏膜及臀部区域均有色素沉着。最初怀疑的低皮质醇血症并无证据，文献检索显示存在维生素B12缺乏的可能性。她患有巨幼细胞贫血，血清维生素B12水平低，主要原因是饮食摄入不佳。补充维生素B12后她的色素沉着消退。皮肤活检显示棘层和基底层色素沉着增加。维生素B12缺乏导致色素沉着的机制是黑色素合成增加。
