[Neuropsychiatric symptoms in vitamin B12 deficiency and microcarcinoidosis. The complications of chronic atrophic gastritis].
METHODS
A 69-year-old woman reported marked restriction of voluntary movements of the hands in the preceding 6 months. She had also experienced loss of motivation, memory and concentration. Her skin was pale yellow, and scratches on her skin indicated marked pruritus.


METHODS
Neurological examination revealed decreased vibratory sense in both legs. Haemoglobin concentration was 8.3 g/dl, mean corpuscular volume 114 fl, vitamin B12 level < 100 ng/l, folic acid level normal. Antibody titre against parietal cells was increased, vitamin B12 resorption diminished. Gastroscopy revealed small raised lesions, made up of hyperplastic cells which stained with chromogranin, indicating a diagnosis of microcarcinoid of the gastric mucosa.


METHODS
On administration of cobalamine (1,000 micrograms i.m. daily for 2 weeks, twice weekly for 6 weeks, then once per week for the last 7 months) the blood picture returned to normal, but the microcarcinoids, the psychological symptoms and the apraxia of the hands were unchanged.
Ossege
L M
LM
Neurologische Klinik, Universität Münster.
Pohle
T
T
Müller
K M
KM
May
B
B
Malin
J P
JP
D000368:Aged; D002276:Carcinoid Tumor / Q000150:complications / Q000175:diagnosis / Q000209:etiology* / Q000523:psychology; D002908:Chronic Disease; D005260:Female; D005757:Gastritis, Atrophic / Q000150:complications* / Q000175:diagnosis / Q000523:psychology; D006397:Hematinics / Q000008:administration & dosage; D006801:Humans; D008569:Memory Disorders / Q000175:diagnosis / Q000209:etiology* / Q000523:psychology; D009422:Nervous System Diseases / Q000175:diagnosis / Q000209:etiology* / Q000523:psychology; D011599:Psychopathology; D013274:Stomach Neoplasms / Q000150:complications / Q000175:diagnosis / Q000209:etiology* / Q000523:psychology; D014805:Vitamin B 12 / Q000008:administration & dosage; D014806:Vitamin B 12 Deficiency / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology / Q000523:psychology
D006397:Hematinics; D014805:Vitamin B 12
Neuro-psychiatrische Symptome bei Vitamin-B12-Mangel und Mikrokarzinoidose. Komplikationen einer chronischen atrophischen Gastritis.