Subacute combined degeneration without nutritional anemia

Miscusi, Massimo; Testaverde, Lorenzo; Rago, Angela; Raco, Antonino; Colonnese, Claudio

doi:10.1016/j.jocn.2012.01.039

Cited by 8 publications

(12 citation statements)

References 8 publications

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“…In our study, nearly one-third of the patients with SCD had normal levels of HGB. Nevertheless, reports of SCD also include cases without anemia [17]. In our study, patients with anemia did not have worse clinical signs or symptoms.…”

Section: Discussionsupporting

confidence: 48%

Subacute Combined Degeneration: A Retrospective Study of 68 Cases with Short-Term Follow-Up

Cao

et al. 2018

Eur Neurol

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Purpose: The study aimed to analyze the clinical characteristics, laboratory test results, neuroimaging findings, and outcomes in patients diagnosed with subacute combined degeneration (SCD). Materials and Methods: A total of 68 patients with SCD who had been appropriately treated for no less than 6 months were included in our study. Histories, results of routine blood tests, biochemical indices, serum vitamin B₁₂ levels, and spinal magnetic resonance imaging (MRI) findings from the patients were studied and analyzed. Clinical signs and symptoms, graded using a functional disability rating scale, were scored at the time of admission and 3 and 6 months after admission. Results: Limb numbness, limb weakness, and gait disturbances were the most common symptoms in patients with SCD. All patients showed clinical improvement to different degrees at the follow-up visits after vitamin B₁₂ treatment. No differences in rating score were found in patients grouped by sex, hemoglobin level, serum vitamin B₁₂, or MRI manifestations at the time of admission or at the follow-up visits. Younger patients and those with shorter disease courses had better rating scores at the short-term follow-up visits. Conclusion: Anemia, low levels of serum vitamin B₁₂, and MRI abnormalities in the spinal cord are not expected to be associated with worse clinical manifestations. The age of onset and course of disease are important in evaluating the short-term prognosis of patients with SCD.

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Section: Discussionsupporting

confidence: 48%

Subacute Combined Degeneration: A Retrospective Study of 68 Cases with Short-Term Follow-Up

Cao

et al. 2018

Eur Neurol

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“…The skewing of haematological parameters (MCV, MCHC, MCH) beyond the upper limit of normal and the presence of macrocytes in the peripheral blood film during the second admission of this patient indicate an evolution of megaloblastic anaemia which is a characteristic haematological manifestation of vitamin B12 deficiency 9 .…”

mentioning

confidence: 72%

“…posterio-lateral column 4,14 while some pathological findings could be multifocal and vacuolated lesions 9 . Early diagnosis and treatment of Subacute Combined Degeneration of the Spinal Cord is important in reversibility of neuro-deficits and prevention of permanent neurological damage 9 .…”

Section: Introductionmentioning

confidence: 99%

“…Inadequate absorption can also result from deficiency of intrinsic factor, a glycoprotein responsible for enhancing the absorption of Vitamin B12 from the terminal ileum 6 and hereditary partial transcobalamin II deficiency 7 . Inadequate intake of vitamin B12 has also been implicated as a major cause of its deficiency especially in vegetarians, simply because vitamin B12 is mainly sourced from animal products 1,5,[8][9][10] . Other recognized causes include side effect of Nitric Oxide, an inhalational general anaesthetic agent, usage of which can precipitate Vitamin B12 deficiency post operatively with its attendant sequelae or when employed in substance abuse by adolescents 2,5,11 .…”

Section: Introductionmentioning

confidence: 99%

“…Early diagnosis and treatment of Subacute Combined Degeneration of the Spinal Cord is important in reversibility of neuro-deficits and prevention of permanent neurological damage 9 . Promptly diagnosed patients respond dramatically to parentheral Vitamin B12 preparations with improvement in neurological functions and prevention of irreversible neuro disabilities.…”

Section: Introductionmentioning

confidence: 99%

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Subacute combined degeneration of the spinal cord in a Nigerian child: a need for a high index of suspicion

Oyinlade¹,

Lagunju²,

Balogun³

et al. 2016

Nig. J. Paed.

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Abstract:Background: Vitamin B12 deficiency has been reported to be associated with a spectrum of neurological disorders among which is subacute combined degeneration of the spinal cord. Method: We report a case of subacute combined degeneration of the spinal cord secondary to vitamin B12 deficiency and discussed the clinical presentation and management challenge. Result: The diagnosis was made through a high index of suspicion when the clinical presentation ranked highly with the mode of presentation of Vitamin B12 deficiency. Patient responded well to parentheral vitamin B12 preparation but subsequently defaulted from follow up for 8 years after which he represented with paraparesis and urinary incontinence. He was managed again with parentheral vitamin B12 preparations with good outcome and total resolution of symptoms at discharge. Conclusion: A high index of suspicion is needed in identifying vitamin B12 deficiency related paraparesis in paediatric practice while the need for indefinite treatment and follow up is hereby emphasized.

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Three-point sign in subacute combined degeneration of the spinal cord

et al. 2018

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Rationale:Subacute combined degeneration (SCD) of the spinal cord has been reported to have distinctive characteristics on magnetic resonance imaging (MRI), such as an “inverted V sign”, a “pair of binoculars sign”, and a “dot sign”. We report a 3-point sign as a novel MRI characteristic, expanding the spectrum of imaging signs for SCD.Patient concerns:A 64-year-old female vegetarian presented with a 3-month history of progressive numbness and weakness in the lower extremities.Diagnosis:Laboratory examination showed a reduced serum vitamin B12 level. Spinal MRI showed hyperintensity within the posterior and lateral columns (appearing as a three-point sign) on T2-weighted imaging. Thus, the patient was diagnosed with SCD.Interventions:The patient was treated with intravenous cyanocobalamin and oral vitamin B12.Outcomes:After a follow-up period of 5 months, the symptoms were significantly improved.Lessons:Clinicians should be aware of this atypical MRI pattern, which may facilitate an early diagnosis.

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Subacute combined degeneration without nutritional anemia

Cited by 8 publications

References 8 publications

Subacute Combined Degeneration: A Retrospective Study of 68 Cases with Short-Term Follow-Up

Subacute Combined Degeneration: A Retrospective Study of 68 Cases with Short-Term Follow-Up

Subacute combined degeneration of the spinal cord in a Nigerian child: a need for a high index of suspicion

Three-point sign in subacute combined degeneration of the spinal cord

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