title: The significance of folate deficiency in alcoholic and nutritional neuropathies: analysis of a case.
abstract: OBJECTIVE
  To elucidate the significance of folate deficiency in alcoholic and nutritional neuropathies.
  
  
  METHODS
  We preformed a comprehensive clinical screening of a patient with chronic alcoholism who manifested neuropathy, macrocytic anemia, liver dysfunction, and folate deficiency.
  
  
  RESULTS
  A 33-y-old woman with chronic alcoholism presented with acutely progressive glove- and stocking-type sensorimotor polyneuropathy. Although an episode of neuropathy preceded the current episode by 2 y, its cause was never determined. The findings of nerve conduction studies were indicative of axonal neuropathy. Laboratory findings revealed macrocytic anemia and liver dysfunction. Her serum level of folate was reduced, whereas thiamine, riboflavin, and cobalamin levels were within normal range. The neuropathy and anemia showed gradual recovery after the initiation of folic acid supplementation.
  
  
  CONCLUSIONS
  This case study indicates that folate deficiency should be monitored closely in patients with chronic alcoholism and associated malnutrition. Additionally, folate deficiency should be considered as a differential diagnosis of neuropathy.
authors.affiliation: Department of Neurology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Haruki
authors.initials: H
authors.lastname: Koike
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Hama
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Kawagashira
authors.forename: Rina
authors.initials: R
authors.lastname: Hashimoto
authors.forename: Minoru
authors.initials: M
authors.lastname: Tomita
authors.forename: Masahiro
authors.initials: M
authors.lastname: Iijima
authors.forename: Gen
authors.initials: G
authors.lastname: Sobue
mesh_terms: D000328:Adult; D020269:Alcoholic Neuropathy / Q000175:diagnosis / Q000209:etiology; D000437:Alcoholism / Q000097:blood / Q000150:complications / Q000503:physiopathology*; D000748:Anemia, Macrocytic / Q000209:etiology / Q000517:prevention & control; D003937:Diagnosis, Differential; D019587:Dietary Supplements; D005260:Female; D005492:Folic Acid / Q000097:blood / Q000627:therapeutic use; D005494:Folic Acid Deficiency / Q000150:complications / Q000178:diet therapy / Q000503:physiopathology*; D006801:Humans; D008108:Liver Diseases, Alcoholic / Q000209:etiology; D011115:Polyneuropathies / Q000175:diagnosis / Q000209:etiology* / Q000517:prevention & control; D016896:Treatment Outcome
chemical_list: D005492:Folic Acid