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病例报告:自身免疫性胃炎导致的亚急性联合变性合并脊髓恶性贫血。

A case report: subacute combined degeneration of the spinal cord and pernicious anemia caused by autoimmune gastritis.

机构信息

From the Department of Neurology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Pudong New District, Shanghai, China.

出版信息

Medicine (Baltimore). 2022 Jul 1;101(26):e29226. doi: 10.1097/MD.0000000000029226.

Abstract

INTRODUCTION

Autoimmune gastritis causing both subacute combined degeneration of the spinal cord and pernicious anemia is rare in clinical practice. Here, we report a case of subacute combined degeneration of the spinal cord and pernicious anemia resulting from vitamin B12 deficiency due to autoimmune gastritis.

PATIENT CONCERNS

A 66-year-old woman presented with a 2-month history of numbness in her extremities.

DIAGNOSES

The diagnoses were (1) autoimmune gastritis (2) subacute combined degeneration of the spinal cord (3) pernicious anemia (4) hypergastrinemia (5) chronic lymphocytic thyroiditis.

INTERVENTIONS

The patient received intramuscular methylcobalamin treatment for 5 days, followed by oral methylcobalamin daily.Outcomes: Symptoms improved, and anemia recovered in the second month after discharge. She discontinued her medication afterward, and the neurological symptoms recurred.

CONCLUSIONS

Autoimmune gastritis can lead to several diseases if not intervened in the early course. Neuropathy and hematopathy recur with treatment discontinuity. Methylcobalamin and adenosylcobalamin are unlikely to be more effective than vitamin B12.

摘要

简介

引起亚急性联合变性和恶性贫血的自身免疫性胃炎在临床实践中较为罕见。本文报告了一例因自身免疫性胃炎引起维生素 B12 缺乏导致亚急性联合变性和恶性贫血的病例。

患者关注

一名 66 岁女性因四肢麻木就诊,病史 2 个月。

诊断

(1)自身免疫性胃炎;(2)亚急性联合变性;(3)恶性贫血;(4)高胃泌素血症;(5)慢性淋巴细胞性甲状腺炎。

干预措施

患者接受了 5 天的肌肉注射甲钴胺治疗,然后每天口服甲钴胺。

结果

出院后第 2 个月,症状改善,贫血恢复。此后她停止了用药,神经症状再次出现。

结论

如果不在早期阶段进行干预,自身免疫性胃炎可能会导致多种疾病。随着治疗的中断,神经病变和血液病变会复发。甲钴胺和腺苷钴胺可能并不比维生素 B12 更有效。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f04f/9239667/d73618151c28/medi-101-e29226-g002.jpg

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