CLINICAL SYNDROME OF VITAMIN B12 DEFICIENCY AN ANALYSIS OF 10 CASES

Abstract

INTRODUCTION Vitamin B12 deficiency
is an important treatable cause of neurologic
illness in our country which usually
presents as Non-compressive Myelopathy,
Peripheral Neuropathy, and higher
function alteration. We herewith analyse
10 Cases of Vitamin B12 deficiency for
their clinical features and laboratory parameters.
METHODS 10 patients who
were diagnosed to have Vitamin B12 deficiency
at the Institute of Neurology between
2011 and 2014 were analysed for
their clinical features and laboratory parameters.
RESULTS Age of patients
ranged from 14-49 years. Nine were
males and one female. Identifiable risk
factors were noted in five patients. Nine
patients had spastic weakness of limbs
with exaggerated reflexes and posterior
column signs. Sensory symptoms and
signs were noted in nine patients. One
patient presented with higher function
alteration only without any myelopathy or
neuropathy. Bladder symptoms were
noted in four and loss of libido and erectile
dysfunction in two. Sensory ataxia
was prominent in eight patients. Low serum
B12 level was noted in all patients. Peripheral
smear was normal in four patients,
normocytic normochromic in three, and dimorphic
in three. MRI spine showed hyperintensities
in spinal cord in one patient.
MRI brain in the patient with dementia
showed T2 and Flair Hyperintensities in the
periventricular region.
CONCLUSIONS This study highlights the
classical clinical features of Vitamin B12
deficiency and also documents the occurrence
of unusual symptoms like loss of libido,
erectile dysfunction and bladder
symptoms.