title: [Difficulties in the diagnosis in the case of subacute paraplegia in a woman with Addison-Biermer disease].
abstract: The following paper presents a case of presently rare serious and non-typical subacutely progressing neurological complications in Addison-Biermer disease in a period before the diagnosis, and effective treatment with vitamin B12 in the advanced process of the nervous system impairment. The patient was a 52-year-old woman with the following (increasingly severe) symptoms occurring over a period of 5 weeks, after an earlier non-related operation: paresis of lower limbs (up to paraplegia), slight paresis of upper limbs, sphincters disorder, numbness and the loss of sensation in the upper and lower limbs, and finally mental deterioration. The woman was admitted to a neurological clinic with the suspected Guillain-Bare syndrome. After an interview and medical examination, with the help of some additional tests and resulting clinical picture, it was diagnosed as the Addison-Biermer disorder. A typical treatment was started with vitamin B12 injections, with a neurological improvement within a week, and further gradual improvement over the following 5 weeks of treatment in the clinic (improvement in the strength, sensation in the limbs, functionality of the sphincters, and normalization of the cognitive functions). After 2 months of continuous pharmacological treatment and physical rehabilitation, the patient started to walk with the help of a walker, and after further 2 months, she was able to walk on her own with a crutch.
authors.affiliation: Klinika Neurologii, Centralny Szpital Kliniczny MSWiA w Warszawie, Warsaw, Poland.
authors.forename: Elzbieta
authors.initials: E
authors.lastname: Szupień
authors.forename: Bozena
authors.initials: B
authors.lastname: Ositek
authors.forename: Jarosław
authors.initials: J
authors.lastname: Pniewski
mesh_terms: D000752:Anemia, Pernicious / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy; D003937:Diagnosis, Differential; D004576:Electromyography; D005260:Female; D006801:Humans; D008875:Middle Aged; D010264:Paraplegia / Q000175:diagnosis* / Q000209:etiology*; D013577:Syndrome; D014805:Vitamin B 12 / Q000627:therapeutic use*
chemical_list: D014805:Vitamin B 12