Reversible myelopathy in a 34-year-old man with vitamin B12 deficiency.
Vitamin B12 deficiency is common, with most patients lacking classic features of advanced severe deficiency. Early diagnosis and treatment prevent severe anemia and irreversible damage to the nervous system. We describe a 34-year-old man with pernicious anemia who presented with clinical and radiologic features of early myelopathy and borderline low serum levels of vitamin B12. Prompt diagnosis based on the measurement of serum methylmalonic acid and treatment with cyanocobalamin injections led to rapid resolution of clinical manifestations and magnetic resonance imaging abnormalities. We review the literature of magnetic resonance imaging in vitamin B12 deficiency myelopathy and discuss the issues relating to diagnosis and early treatment of this potentially reversible condition.
Pittock
Sean J
SJ
Department of Neurology, Mayo Clinic, Rochester, Minn 55905, USA. pittock.sean@mayo.edu
Payne
Troy A
TA
Harper
C Michel
CM
D000328:Adult; D003937:Diagnosis, Differential; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008764:Methylmalonic Acid / Q000097:blood; D010292:Paresthesia / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D013118:Spinal Cord Diseases / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D013997:Time Factors; D016896:Treatment Outcome; D014805:Vitamin B 12 / Q000627:therapeutic use; D014806:Vitamin B 12 Deficiency / Q000097:blood / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy
D008764:Methylmalonic Acid; D014805:Vitamin B 12