Demko Andrew W, Rustom David H
Pain Management, Wayne State University Detroit Medical Center, Detroit, USA.
Cureus. 2024 Jul 7;16(7):e64027. doi: 10.7759/cureus.64027. eCollection 2024 Jul.
Subacute combined degeneration (SCD) is a reversible cause of posterior and lateral spinal cord degeneration. Prolonged vitamin B12 deficiency is a common cause of SCD as it leads to inhibition of proper myelin synthesis and reduces myelin integrity. When left untreated, SCD causes progressive debility that can lead to irreversible damage. We describe the case of a 49-year-old male patient who presented with one year of worsening weakness, back pain, paresthesias, and gait abnormalities. Laboratory values revealed vitamin B12 deficiency, elevated homocysteine and methylmalonic acid, and megaloblastic anemia. Following a diagnosis of SCD, the patient began treatment with intramuscular vitamin B12, and his pain and ambulation improved considerably in the following weeks. Prompt identification of vitamin B12 deficiency can lead to considerable improvements in function and quality of life.
亚急性联合变性（SCD）是脊髓后索和侧索变性的一个可逆病因。长期维生素B12缺乏是SCD的常见病因，因为它会导致正常髓鞘合成受到抑制并降低髓鞘完整性。若不治疗，SCD会导致进行性衰弱，进而可能造成不可逆损害。我们描述了一例49岁男性患者的病例，该患者出现了为期一年的逐渐加重的虚弱、背痛、感觉异常和步态异常。实验室检查结果显示维生素B12缺乏、同型半胱氨酸和甲基丙二酸升高，以及巨幼细胞贫血。在诊断为SCD后，患者开始接受肌肉注射维生素B12治疗，在接下来的几周里，他的疼痛和行走能力有了显著改善。及时识别维生素B12缺乏可使功能和生活质量得到显著改善。
