Almoallim Hani, Mehdawi Fahtima S, Cheikh Mohammed M, Al-Dhaheri Fahmi, Aqeel Abdullah Mahir
Alzaidi Chair of Research, Department of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia; Soliman Fakeeh Hospital, Jeddah, Saudi Arabia.
Department of Medicine, Soliman Fakeeh Hospital, Jeddah, Saudi Arabia.
Case Rep Neurol Med. 2016;2016:4301769. doi: 10.1155/2016/4301769. Epub 2016 Dec 13.
Vitamin B12 is essential for neurological function and its deficiency is associated with many neuropsychiatric disorders. We report the case of a previously healthy 53-year-old male patient presenting with delirium and multiple neurological findings. Complete blood analysis indicated megaloblastic anemia. All infectious causes were excluded owing to negative cultures (blood and urine). Tests for human immunodeficiency virus, syphilis, and toxoplasma were also negative. Metabolic workup showed severe vitamin B12 deficiency, decreased reticulocyte count, and increased direct bilirubin and lactate dehydrogenase. Intramuscular injection of cobalamin was started, and the patient showed significant improvement.
维生素B12对神经功能至关重要，其缺乏与多种神经精神疾病有关。我们报告了一例先前健康的53岁男性患者，出现谵妄和多种神经系统表现。全血细胞分析显示巨幼细胞贫血。由于培养结果（血液和尿液）为阴性，排除了所有感染性病因。人类免疫缺陷病毒、梅毒和弓形虫检测也均为阴性。代谢检查显示严重维生素B12缺乏、网织红细胞计数降低、直接胆红素和乳酸脱氢酶升高。开始肌肉注射钴胺素，患者病情显著改善。
