Playas PG, Orozco PJ, López RM, Ramos RR, Collazo JJ, Amavisca ER

Language: Spanish
References: 14
Page: 88-92
PDF size: 93.12 Kb.

ABSTRACT

The megaloblastic anemia in mild climates is the main cause of the deficiency of cobalamine, is a disease of the elderly, affects males and females equally, and appears in average at 60 years of age. In the megaloblastic anemia is autoimmunity against gastric parietal cells, therefore there is an absence of intrinsic factor. The spinal cord, brain, and optic and peripheral nerves can be affected because of B12 vitamin (cobalamine) deficiency. The spinal cord is usually the first to be affected and often the only one. It is used the term subacute combined system disease regarding to a lesion of the spinal cord secondary to B12 vitamin deficiency. The earliest histological change is the nerve demyelination. The clinical manifestations includes generalized weakness and paresthesias in feet and hands, besides irritability, apathy, somnolence and emotional instability, even depressive or confusional psychosis. The physical exam exhibits posterior and lateral column involvement of the spinal cord. The diagnosis is based on the measurement of seric B12 nivel. The treatment must begin as soon as the diagnosis is made.

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