Junco BMD

Language: Spanish
References: 16
Page: 209-217
PDF size: 246.19 Kb.

ABSTRACT

Background: deficiency of vitamin B12 (cyanocobalamin) can produce some neurological disorders like peripheral neuropathy, subacute combined degeneration of spinal cord, optic neuropathy, as well as cognitive alterations that go from mild confusion to dementia or psychosis. The most frequent cause of deficiency of vitamin B12 is pernicious anemia.
Objective: to present a clinical case of dementia caused by deficit of vitamin B12.
Clinical case: a fifty-year-old male patient who is married and a self-employed worker, presented manifestations of insidious beginning with memory failure, apathy, and depression. Progressively, an inadequate conduct, delirious ideas of pursuit and spatial disorientation were added to the manifestations; that’s why he had to stop working. The mental test when admitted showed bradypsychia, apathy and a suspicious behaviour.
Conclusions: dementia caused by deficiency of vitamin B12 is a rare complaint but some cases have been reported in the medical literature.

REFERENCES

1. Hoffman R, Benz EJ, Furie B, Shattil SJ. Hematology: Basic Principles and Practice. Philadelphia, Pa: Churchill Livingstone; 2009.

2. Elmadfa I, Singer I. Vitamin B-12 and homocysteine status among vegetarians: a global perspective. Am J Clin Nutr. May 2009;89(5):1693S-1698S.

3. Lindenbaum J, Healton EB, Savage DG, Brust JC M, Garrett TJ, Podell ER, et al. Neuropsychiatric disorders caused by cobalamin deficiency in the absence of anemia or macrocytosis. N Engl J Med. 1988;318:1720-8. .

4. Andrès E, Vogel T, Federici L, Zimmer J, Ciobanu E, Kaltenbach G. Cobalamin deficiency in elderly patients: a personal view. Curr Gerontol Geriatr Res. 2008;848267.

5. Erkurt MA, Aydogdu I, Dikilitas M, Kuku I, Kaya E, Bayraktar N, et al. Effects of cyanocobalamin on immunity in patients with pernicious anemia. Med Princ Pract. 2008;17(2):131-5.

6. Graber JJ, Sherman FT, Kaufmann H, Kolodny EH, Sathe S. Vitamin B12-responsive severe leukoencephalopathy and autonomic dysfunction in a patient with "normal" serum B12 levels. J Neurol Neurosurg Psychiatry. 2010 Dec;81(12):1369-71.

7. Andres E, Serraj K. Optimal management of pernicious anemia. J Blood Med. 2012;3:97-103.

8. Favrat B, Vaucher P, Herzig L. Oral vitamin B12 for patients suspected of subtle cobalamin deficiency: a multicentre pragmatic randomised controlled trial. BMC Fam Pract. 2011 13 Jan;12:2.

9. Wang YH, Yan F, Zhang WB, Ye G, Zheng YY, Zhang XH, et al. An investigation of vitamin B12 deficiency in elderly inpatients in neurology department. Neurosci Bull. 2009 Aug;25(4):209-15.

10. Braunwald E, Fauci AS, Kasper DL, Hauser SL, Longo DL, Jameson JL. Harrison's Principles of Internal Medicine. 15th ed. New York, NY: McGraw Hill; 2001.

11. Dali-Youcef N, Andres E. An update on cobalamin deficiency in adults. QJM. 2009 Jan;102(1):17-28. .

12. Filioussi K, Bonovas S, Katsaros T. Should we screen diabetic patients using biguanides for megaloblastic anaemia? Aust Fam Physician. 2003 May;32(5):383-4.

13. Gomber S, Dewan P, Dua T. Homocystinuria: a rare cause of megaloblastic anemia. Indian Pediatr. 2004 Sep;41(9):941-3.

14. Borgna-Pignatti C, Azzalli M, Pedretti S. Thiamine-responsive megaloblastic anemia syndrome: long term follow-up. J Pediatr. 2009 Aug;155(2):295-7.

15. Molloy AM, Kirke PN, Brody LC, Scott JM, Mills JL. Effects of folate and vitamin B12 deficiencies during pregnancy on fetal, infant, and child development. Food Nutr Bull. 2008 Jun;29(2 Suppl):S101-11.

16. Varela-Moreiras G, Murphy MM, Scott JM. Cobalamin, folic acid, and homocysteine. Nutr Rev. 2009 May;67 Suppl 1:S69-72.