Ischemic strokes secondary to vitamin B12 deficiency-induced hyperhomocystinemia.
A 45-year-old woman sustained two ischemic cerebral infarctions 16 years after ileal resection for Crohn's disease. Her evaluation showed an elevated random serum homocystine level, a low serum vitamin B12 level, and an increased mean corpuscular volume (MCV) without anemia. A methionine-loading test resulted in a marked increase in the homocystine levels 2, 4, and 6 hours after the load. A Schilling test demonstrated a malabsorption of vitamin B12. Vitamin B12 injections normalized her fasting homocystine level and her MCV. She has had no recurrent strokes during a year follow-up.
Department of Neurology and the Stroke Program of the Sanders-Brown Center on Aging, University of Kentucky, Lexington, USA.
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Penix
D002545:Brain Ischemia / Q000097:blood / Q000209:etiology*; D005260:Female; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D008875:Middle Aged; D014806:Vitamin B 12 Deficiency / Q000097:blood / Q000150:complications*
D006710:Homocysteine