Saji Anu M., Lui Forshing, De Jesus Orlando
Father Muller Medical College Hospital
CA Northstate Uni, College of Med
Subacute combined degeneration (SCD) of the spinal cord is a disease affecting the lateral and posterior columns of the spinal cord, primarily due to demyelination. It most commonly presents in patients deficient in vitamin B12, producing hematological and neurological manifestations. The condition commonly presents with sensory deficits, paresthesia, weakness, ataxia, and gait disturbances. Vitamin B12 is an active cofactor in the synthesis of deoxyribonucleic acid (DNA) and myelin. It can be caused by inadequate oral intake of vitamin B12 and poor absorption of vitamin B12 due to gastrectomy, ileal resection, intake of certain medications, or bacterial overgrowth. SCD can be caused by the use and misuse of nitrous oxide. It can also be caused by copper deficiency resulting from excessive zinc consumption.[3] These are less common yet important causes to recognize in clinical practice. Unexplained anemia, coupled with neurological symptoms, should raise suspicions of SCD, and an evaluation investigating vitamin B12 or, less commonly, copper deficiency in susceptible populations should be initiated.
脊髓亚急性联合变性（SCD）是一种主要由于脱髓鞘而影响脊髓侧索和后索的疾病。它最常见于维生素B12缺乏的患者，会产生血液学和神经学表现。该病通常表现为感觉缺陷、感觉异常、虚弱、共济失调和步态障碍。维生素B12是脱氧核糖核酸（DNA）和髓鞘合成中的一种活性辅因子。它可由维生素B12口服摄入不足以及因胃切除术、回肠切除术、某些药物的摄入或细菌过度生长导致的维生素B12吸收不良引起。SCD可由一氧化二氮的使用和滥用导致。它也可由过量摄入锌导致铜缺乏引起。[3]这些在临床实践中是不太常见但很重要的可识别病因。不明原因的贫血，再加上神经症状，应引起对SCD的怀疑，并且应针对易感人群启动对维生素B12或较少见的铜缺乏进行调查的评估。
