以急性痴呆、双下肢轻瘫和正常血红蛋白为表现的可逆性维生素B12缺乏症
Reversible Vitamin B12 Deficiency Presenting with Acute Dementia, Paraparesis, and Normal Hemoglobin.
作者信息
Almoallim Hani, Mehdawi Fahtima S, Cheikh Mohammed M, Al-Dhaheri Fahmi, Aqeel Abdullah Mahir
机构信息
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.
出版信息
Case Rep Neurol Med. 2016;2016:4301769. doi: 10.1155/2016/4301769. Epub 2016 Dec 13.
Abstract
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.
摘要
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。
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本文引用的文献
1
Vitamin B12 deficiency with combined hematological and neuropsychiatric derangements: a case report.维生素B12缺乏伴血液学和神经精神系统联合紊乱：一例报告
J Med Case Rep. 2014 Aug 15;8:277. doi: 10.1186/1752-1947-8-277.
2
Clinical practice. Vitamin B12 deficiency.临床实践。维生素B12缺乏症。
N Engl J Med. 2013 Jan 10;368(2):149-60. doi: 10.1056/NEJMcp1113996.
3
An analysis of clinical reasoning through a recent and comprehensive approach: the dual-process theory.通过一种最新且全面的方法分析临床推理：双加工理论。
Med Educ Online. 2011 Mar 14;16. doi: 10.3402/meo.v16i0.5890.
4
Chronic psychosis associated with vitamin B12 deficiency.
J Assoc Physicians India. 2008 Feb;56:115-6.
5
[Review of the role of hyperhomocysteinemia and B-vitamin deficiency in neurological and psychiatric disorders--current evidence and preliminary recommendations].[高同型半胱氨酸血症和B族维生素缺乏在神经和精神疾病中的作用综述——当前证据及初步建议]
Fortschr Neurol Psychiatr. 2007 Sep;75(9):515-27. doi: 10.1055/s-2007-980112.
6
Vitamin B12, folic acid, and the nervous system.维生素B12、叶酸与神经系统
Lancet Neurol. 2006 Nov;5(11):949-60. doi: 10.1016/S1474-4422(06)70598-1.
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Clinical and laboratory features and response to treatment in patients presenting with vitamin B12 deficiency-related neurological syndromes.维生素B12缺乏相关神经综合征患者的临床和实验室特征及治疗反应
Neurol India. 2005 Mar;53(1):55-8; discussion 59. doi: 10.4103/0028-3886.15057.
8
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10
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Mayo Clin Proc. 1994 Feb;69(2):144-50. doi: 10.1016/s0025-6196(12)61041-6.
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