Gross J S, Weintraub N T, Neufeld R R, Libow L S
J Am Geriatr Soc. 1986 Aug;34(8):612-4. doi: 10.1111/j.1532-5415.1986.tb05768.x.
It is well known that the neurologic manifestations of vitamin B12 deficiency can occur in the absence of anemia. The authors recently observed two elderly patients who presented to a chronic care institution with the diagnosis of dementia, and in both individuals low serum B12 levels were found in conjunction with abnormal Schilling tests. In neither of these two patients was there anemia or macrocytosis. After receiving parenteral B12 injections there was improvement noted in cognitive functions as well as in activities of daily living. The authors are reporting these patients to alert clinicians to the fact that pernicious anemia in the elderly can first present with low serum B12 levels and neurologic abnormalities in the absence of anemia or macrocytosis.
众所周知，维生素B12缺乏的神经系统表现可在无贫血的情况下出现。作者最近观察到两名老年患者，他们因痴呆诊断入住一家慢性病护理机构，两人血清B12水平均低，同时希林试验异常。这两名患者均无贫血或大细胞症。接受维生素B12注射后，认知功能以及日常生活活动均有改善。作者报告这些患者，以提醒临床医生注意，老年恶性贫血最初可能表现为血清B12水平低和神经系统异常，而无贫血或大细胞症。
