Súbtil J C, Betés M, Corella C, Iriarte J, Muñoz-Navas M A
Servicio de Digestivo, Clínica Universitaria de Navarra, Pamplona.
Rev Esp Enferm Dig. 1996 Jun;88(6):431-3.
We report the case of a patient in the Psychiatric Department who complained of progressive impairment of cerebral functions consistent with dementia, diarrhea and fecal incontinence in the last few months. His medical history included a Billroth II gastrectomy for gastric ulcer. Biochemical tests detected cobalamin deficiency, without megaloblastic anemia, and an abnormal Schilling test that was not due to intrinsic factor deficiency. Once other causes of cobalamin deficiency were ruled out, we considered it as a deficiency disease due to blind loop syndrome. Treatment with parenteral vitamin B complex and long term oral antibiotic therapy allowed the complete and permanent resolution of neurologic and digestive symptoms. We consider this case to be interesting because it shows the existence of curable dementias and the usefulness of taking into account bacterial overgrowth, usually underestimated, as an entity that can produce a variety of disorders.
我们报告了一名精神科患者的病例，该患者在过去几个月中出现了与痴呆症相符的进行性脑功能损害、腹泻和大便失禁。他的病史包括因胃溃疡进行的毕Ⅱ式胃切除术。生化检查发现钴胺素缺乏，但无巨幼细胞贫血，且Schilling试验异常，并非由内因子缺乏引起。排除其他钴胺素缺乏原因后，我们认为这是一种由于盲袢综合征导致的营养缺乏病。胃肠外复合维生素B治疗及长期口服抗生素治疗使神经和消化症状完全且永久缓解。我们认为这个病例很有意思，因为它表明存在可治愈的痴呆症，同时也显示出考虑通常被低估的细菌过度生长这一可导致多种疾病的因素的重要性。
