Schönlein-Henoch Syndrome Due to Chocolate

Symposium on Neurological Abnormalities Found in Association with Various Forms of Macrocytic Anæmia

“…It has been described after total gastrectomy (Dennig 1929) and more frequently after partial gastrectomy (Rowlands & 1954). It has been reported in patients after gastroenterostomy (Naish & Capper 1953) and also occurs in patients with strictures, blind loops, multiple diverticula or short circuits of the small intestine (Cameron et al 1949, Krevans et al 1954, Richmond & Davidson 1958, Badenoch et al 1955, Wilkinson 1955, Halstead et al 1956.…”

“…It is uncertain whether vitamin B12 neuropathy occurs in gluten-induced enteropathy (idiopathic steatorrhcea). A possible case has been described by Richmond & Davidson (1958) but if it does occur it is extremely rare. However, the condition does occur in chronic tropical sprue, sometimes many years after these patients have left the tropics (Booth & Mollin 1964).…”

“…Optic neuritis also occurs (Cohen 1936, Benham 1951, McAlpine & Goldsmith 1951, Hyland & Sharpe 1952 and tobacco amblyopia may be precipitated by the deficiency (Leishman 1952, Heaton et al 1958. The term 'subacute combined degeneration of the cord' which is commonly used to describe the neurological lesions of vitamin B12 deficiency is obviously unsatisfactory and it has been suggested that 'vitamin B12 neuropathy' should be used instead (Richmond & Davidson 1958). Megaloblastic anamia due to folate deficiency has been found in patients with nutritional polyneuritis or with Wernicke's encephalopathy (Smith & Woodruff 1951, Victor & Lear 1956; in patients with chronic neurological and psychiatric disorders (Mollin & Selwyn 1956, unpublished observations) and in polyneuritis of unknown origin (Grant et al 1965).…”

Symposium on Neurological Abnormalities Found in Association with Various Forms of Macrocytic Anæmia

“…With better management and longer survival of patients at risk of malabsorption, the delayed manifestation of vitamin B12 deficiency due to this cause (Richmond & Davidson 1958) is likely to be seen from time to time, as many years may have to pass before the reserves of vitamin B12 dry up (Weir & Gatenby 1963). The risk of deficiency will be greater in the patient with a slight defect of absorption since Section of Neurology those with a severe lesion will have had replacement therapy (Anderson 1965).…”

Non-Addisonian Megaloblastic Anaemia, Complicated by Subacute Combined Degeneration of the Cord

“…One such type is associated with structural intestinal changes such as fistulae or anastomoses, with diversion of vitamin B,2 by bacteria in stagnant areas of bowel, and another with malabsorption of vitamin B,2 due to short-circuit operations or small-bowel infiltration by tuberculosis or tuimour. Richmond and Davidson (1958) found only five cases of each type in the literature, and described one further case of each type of their own.…”