Medknow Publications on behalf of the Neurological Society of India
Vol. 53, No. 1, 2005, pp. 55-58
Bioline Code: ni05014
Full paper language: English
Document type: Research Article
Document available free of charge
Neurology India, Vol. 53, No. 1, 2005, pp. 55-58
© Copyright 2005 Neurology India.
Clinical and laboratory features and response to treatment in patients presenting with vitamin B12 deficiency-related neurological syndromes|
Aaron S, Kumar Sudhir, Vijayan J, Jacob J, Alexander M, Gnanamuthu C
AIMS AND OBJECTIVES:
To study the clinical and laboratory features of patients admitted with vitamin B12 deficiency-related (B12def) neurological syndromes.
SETTINGS AND DESIGN:
A hospital-based retrospective and prospective study conducted at a referral teaching hospital.
MATERIALS AND METHODS:
Consecutive patients admitted with vitamin B12deficiency-related neurological disorders during a three-year period from June 2000 to May 2003 were included. Data regarding clinical and laboratory features were obtained. Follow-up was done at least six months following treatment with parenteral vitamin B12. Chi-square test was used for statistical analysis.
A total of 63 patients (52 males) with a mean age of 46.2 years were studied. The mean duration of symptoms at presentation was 10.3 months. Myeloneuropathy (54%) was the commonest neurological manifestation, followed by myeloneuropathy with cognitive dysfunction (34%), and peripheral neuropathy (9%). Neuropsychiatric manifestations and dementia were observed in 38% and 19% of patients respectively. All the patients had megaloblastic changes in the bone marrow smear. Eleven (17.5%) patients had both hemoglobin and the mean corpuscular volume (MCV) within the normal range. Follow-up after at least six months of therapy with parenteral B12 showed improvement in 54% patients.
A high index of suspicion of B12def is required in patients presenting with myelopathy, cognitive decline, or neuropathy. A normal hemoglobin or MCV does not exclude B12def; therefore, other tests such as bone marrow smear and serum vitamin B12 assay are essential, as the condition is often reversible with treatment.
Bone marrow smear, Vitamin B12 deficiency, Myeloneuropathy
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