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病例报告:自身免疫性胃炎导致严重维生素B12缺乏引起的可逆性舞蹈症:一项综合病例研究。

Case Report: Reversible chorea arising from severe vitamin B12 deficiency due to autoimmune gastritis: a comprehensive case study.

作者信息

Yang Meifang, Geng Yifan, Chen Zhiren, Zhou Zixuan, Huang Wenjuan, Chen Weiwei, Zhang Xia

机构信息

Department of Neurology, Xuzhou Central Hospital, Xuzhou Clinical School of Xuzhou Medical University, Xuzhou School of Clinical Medicine of Nanjing Medical University, Xuzhou, Jiangsu, China.

Southeast University Affiliated Xuzhou Central Hospital, Xuzhou, Jiangsu, China.

出版信息

Front Nutr. 2025 Aug 21;12:1590837. doi: 10.3389/fnut.2025.1590837. eCollection 2025.

Abstract

Cognitive impairment, ocular neuropathy, sensorimotor polyneuropathy, and subacute combined spinal cord degeneration can all result from a common illness called vitamin B12 insufficiency. With regard to extrapyramidal movement disorders, it is rare, frequently misdiagnosed, and under recognized, which postpones timely treatment. A case study of a 66-year-old man with acute-onset and reversible choreoathetoid symptoms is presented in this publication. A significant vitamin B12 deficiency and an abnormal hypermetabolism in the basal ganglia region were detected by 18F-FDG PET/CT. Remarkably, the patient's dyskinesia disappeared as soon as vitamin B12 replacement therapy was administered. The patient's etiology was identified as a mix of vitamin B12 malabsorption and inadequate intake from autoimmune-related gastritis. In order to achieve the best potential therapeutic results, this case highlights the importance of timely and correct diagnosis, timely treatment of vitamin B12 deficiency based on its underlying etiology, and careful research of multiple etiologies.

摘要

认知障碍、视神经病变、感觉运动性多发性神经病变以及亚急性联合变性脊髓病都可能由一种名为维生素B12缺乏症的常见疾病引起。关于锥体外系运动障碍,这种情况很罕见,经常被误诊且认识不足,从而延误了及时治疗。本文发表了一例66岁男性急性起病且症状可逆的舞蹈手足徐动症病例研究。通过18F-FDG PET/CT检测到显著的维生素B12缺乏以及基底节区代谢异常增高。值得注意的是,一旦给予维生素B12替代治疗,患者的运动障碍就消失了。该患者的病因被确定为自身免疫性胃炎导致的维生素B12吸收不良和摄入不足。为了取得最佳的潜在治疗效果,本病例强调了及时正确诊断、根据潜在病因及时治疗维生素B12缺乏以及仔细研究多种病因的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e28f/12408260/dd33e89baaeb/fnut-12-1590837-g001.jpg

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