title: Reversible Vitamin B12 Deficiency Presenting with Acute Dementia, Paraparesis, and Normal Hemoglobin.
abstract: Vitamin B12 is essential for neurological function and its deficiency is associated with many neuropsychiatric disorders. We report the case of a previously healthy 53-year-old male patient presenting with delirium and multiple neurological findings. Complete blood analysis indicated megaloblastic anemia. All infectious causes were excluded owing to negative cultures (blood and urine). Tests for human immunodeficiency virus, syphilis, and toxoplasma were also negative. Metabolic workup showed severe vitamin B12 deficiency, decreased reticulocyte count, and increased direct bilirubin and lactate dehydrogenase. Intramuscular injection of cobalamin was started, and the patient showed significant improvement.
authors.affiliation: Alzaidi Chair of Research, Department of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia; Soliman Fakeeh Hospital, Jeddah, Saudi Arabia.
authors.forename: Hani
authors.identifier: 0000-0003-2582-8317
authors.initials: H
authors.lastname: Almoallim
authors.affiliation: Department of Medicine, Soliman Fakeeh Hospital, Jeddah, Saudi Arabia.
authors.forename: Fahtima S
authors.initials: FS
authors.lastname: Mehdawi
authors.affiliation: Department of Medicine, Soliman Fakeeh Hospital, Jeddah, Saudi Arabia.
authors.forename: Mohammed M
authors.initials: MM
authors.lastname: Cheikh
authors.affiliation: Department of Medicine, Soliman Fakeeh Hospital, Jeddah, Saudi Arabia.
authors.forename: Fahmi
authors.initials: F
authors.lastname: Al-Dhaheri
authors.affiliation: Umm Al-Qura University, Makkah, Saudi Arabia.
authors.forename: Abdullah Mahir
authors.initials: AM
authors.lastname: Aqeel