title: Cobalamin deficiency: clinical picture and radiological findings.
abstract: Vitamin B12 deficiency causes a wide range of hematological, gastrointestinal, psychiatric and neurological disorders. Hematological presentation of cobalamin deficiency ranges from the incidental increase of mean corpuscular volume and neutrophil hypersegmentation to symptoms due to severe anemia, such as angor, dyspnea on exertion, fatigue or symptoms related to congestive heart failure, such as ankle edema, orthopnea and nocturia. Neuropsychiatric symptoms may precede hematologic signs and are represented by myelopathy, neuropathy, dementia and, less often, optic nerve atrophy. The spinal cord manifestation, subacute combined degeneration (SCD), is characterized by symmetric dysesthesia, disturbance of position sense and spastic paraparesis or tetraparesis. The most consistent MRI finding is a symmetrical abnormally increased T2 signal intensity confined to posterior or posterior and lateral columns in the cervical and thoracic spinal cord. Isolated peripheral neuropathy is less frequent, but likely overlooked. Vitamin B12 deficiency has been correlated negatively with cognitive functioning in healthy elderly subjects. Symptoms include slow mentation, memory impairment, attention deficits and dementia. Optic neuropathy occurs occasionally in adult patient. It is characterized by symmetric, painless and progressive visual loss. Parenteral replacement therapy should be started soon after the vitamin deficiency has been established.
authors.affiliation: Department of Neurosciences, Neurological, Psychiatric, Sensorial, Reconstructive and Rehabilitative Sciences, University of Padova, Via Giustiniani 5, Padova 35128, Italy. chiara.briani@unipd.it.
authors.forename: Chiara
authors.initials: C
authors.lastname: Briani
authors.forename: Chiara
authors.initials: C
authors.lastname: Dalla Torre
authors.forename: Valentina
authors.initials: V
authors.lastname: Citton
authors.forename: Renzo
authors.initials: R
authors.lastname: Manara
authors.forename: Sara
authors.initials: S
authors.lastname: Pompanin
authors.forename: Gianni
authors.initials: G
authors.lastname: Binotto
authors.forename: Fausto
authors.initials: F
authors.lastname: Adami
mesh_terms: D003072:Cognition Disorders / Q000097:blood / Q000209:etiology; D006801:Humans; D009420:Nervous System / Q000473:pathology*; D009901:Optic Nerve Diseases / Q000097:blood / Q000209:etiology; D010523:Peripheral Nervous System Diseases / Q000097:blood / Q000209:etiology; D052879:Subacute Combined Degeneration / Q000097:blood; D014805:Vitamin B 12 / Q000097:blood*; D014806:Vitamin B 12 Deficiency / Q000097:blood / Q000150:complications* / Q000523:psychology / Q000628:therapy
chemical_list: D014805:Vitamin B 12