Shimozono Koji
Department of Internal Medicine, Otemachi Hospital.
Rinsho Shinkeigaku. 2021 Jul 30;61(7):461-465. doi: 10.5692/clinicalneurol.cn-001551. Epub 2021 Jun 18.
A 66-year old man presented to our hospital due to gait disturbance. He was unable to stand or walk without assistance. Laboratory tests revealed macrocytic anemia and an extremely low serum vitamin B level. MRI showed high- intensity signals in the posterior and lateral column of the cervical and thoracic region of the spinal cord in T weighted image. Other significant laboratory results were an increased and/or positive anti-thyroid peroxidase antibody, anti-gastric parietal cell antibody and anti-intrinsic factor antibody. He was diagnosed with a combination of Hashimoto's thyroiditis, pernicious anemia and subacute combined degeneration of the spinal cord (SCD). The patient's condition was autoimmune polyglandular syndrome type3B. The association of thyroid and gastric autoimmune disorders is a unique syndrome that tend to be complicated by vitamin B deficiency.
一名66岁男性因步态障碍前来我院就诊。他在没有帮助的情况下无法站立或行走。实验室检查显示大细胞性贫血和血清维生素B水平极低。磁共振成像(MRI)在T加权图像中显示脊髓颈段和胸段后柱及侧柱有高强度信号。其他重要的实验室检查结果是抗甲状腺过氧化物酶抗体、抗胃壁细胞抗体和抗内因子抗体升高和/或呈阳性。他被诊断为桥本甲状腺炎、恶性贫血和脊髓亚急性联合变性(SCD)并存。该患者的病情为3B型自身免疫性多腺体综合征。甲状腺和胃自身免疫性疾病的关联是一种独特的综合征,往往会并发维生素B缺乏。