Huang Xiao-Jiang, He Jia, Qu Wen-Sheng, Tian Dai-Shi
Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China.
Case Rep Neurol Med. 2015;2015:327046. doi: 10.1155/2015/327046. Epub 2015 Sep 7.
Background. Subacute combined degeneration (SCD) is a rare cause of demyelination of the dorsal and lateral columns of spinal cord and is a neurogenic complication due to cobalamin deficiency. Anemia of chronic disease (ACD) occurs in patients with acute or chronic immune activation, including infective endocarditis. It remains to be elucidated whether ACD patients are more sensitive to suffer from SCD. Little cases about SCD patients accompanied with ACD have been reported till now. Here we reported a 36-year-old man with SCD with a medical history of mitral inadequacy over 20 years, who was admitted and transported from another hospital to our hospital due to an 8-month history of gait disturbance, lower limb weakness and paresthesia, and loss of proprioception. Significant laboratory results and echocardiography suggest iron deficiency anemia and infective endocarditis (IE). The SCD diagnosis was confirmed by MRI, which showed selective demyelination in the dorsal and lateral columns of spinal cord. In conclusion, the ACD patients may suffer from SCD, which can be diagnosed by 3 Tesla magnetic resonance imaging.
背景。亚急性联合变性（SCD）是脊髓背侧和外侧柱脱髓鞘的罕见原因，是由于钴胺素缺乏引起的神经源性并发症。慢性病贫血（ACD）发生于急性或慢性免疫激活的患者，包括感染性心内膜炎。ACD患者是否更易患SCD仍有待阐明。迄今为止，关于SCD患者合并ACD的病例报道较少。在此，我们报告一名36岁患有SCD的男性，有超过20年的二尖瓣功能不全病史，因8个月的步态障碍、下肢无力、感觉异常和本体感觉丧失病史，从另一家医院转入我院。显著的实验室检查结果和超声心动图提示缺铁性贫血和感染性心内膜炎（IE）。SCD诊断通过MRI得以证实，MRI显示脊髓背侧和外侧柱有选择性脱髓鞘。总之，ACD患者可能罹患SCD，可通过3特斯拉磁共振成像进行诊断。
