Reversible dementia and neuropathy associated with folate deficiency 16 years after partial gastrectomy.
A 57-year-old woman developed dementia and peripheral neuropathy 16 years after a partial gastrectomy (Billroth II). Serum cobalamin was 198 pmol/l (reference interval 150-550), and the vitamin B12 absorption test (Schilling) showed decreased absorption (1.7% without and 2.2% with intrinsic factor). In spite of 20 months' therapy with vitamin B12, the neurological symptoms progressed. Folate deficiency was suggested by a very low erythrocyte folate and a slightly abnormal FIGLU test. There were no other signs of general malabsorption. A few months' treatment with folic acid significantly improved the massive neurological manifestations which were verified neurophysiologically as well as histologically. A common role of vitamin B12 and folate in the development of neuropathy is suggested.
D003704:Dementia / Q000188:drug therapy / Q000209:etiology*; D005365:FIGLU Test; D005260:Female; D005492:Folic Acid / Q000627:therapeutic use; D005494:Folic Acid Deficiency / Q000150:complications* / Q000188:drug therapy / Q000209:etiology; D005743:Gastrectomy / Q000009:adverse effects*; D006801:Humans; D008875:Middle Aged; D010523:Peripheral Nervous System Diseases / Q000209:etiology*; D012546:Schilling Test; D013997:Time Factors; D014805:Vitamin B 12 / Q000627:therapeutic use
D005492:Folic Acid; D014805:Vitamin B 12