Vitamin B12 Eksikliğine Bağlı ‘Subakut Kombine Dejenerasyon’: Bir Olgu Nedeniyle Gözden Geçirme

  • Ümit Görgülü
  • Ufuk Ergün S.B. Ankara Eğitim ve Araştırma Hastanesi Nöroloji Kliniği
  • Pelin Kavak
  • Levent Ertuğrul İnan
  • Tahir Kurtuluş Yoldaş

Abstract

Vitamin B12 eksikliği; nöropati, myelopati, demans, nöropsikiyatrik bulgular ve optik nöropati ile presente olabilir. Subakut kombine dejenerasyon (SKD) olarak bilinen B12 vitamini eksikliğine bağlı spinal kord tutulumu, nörolojik bozuklukların %10’unu oluşturur. B12 eksikliğinin nöroloji pratiğinde sık görülmesi ve önemi nedeniyle, b12 vitamini eksikliğine bağlı reversibl spinal kord tutulumu olan bir olguyu, klinik ve görüntüleme bulguları ile birlikte ayrıntılı olarak gözden geçirerek sunduk. 

References

Bradley WG, Daroff RB, Fenichel GM. Çeviri editörü: Tan E, Özdamar SE, Neurology in Clinical Practice. Beşinci edisyon. İstanbul: Veri Medikal Yayıncılık; 2008; Bölüm 61, Sinir Sisteminin Eksiklere Bağlı Bozuklukları. Say:1643-55.

Chiara Briani, Chiara Dalla Torre, Valentina Citton , Renzo Manara, Sara Pompanin, Gianni Binotto and Fausto Adami, Review Cobalamin Deficiency: Clinical Picture and Radiological Findings. Nutrients 2013; 5: 4521-4539.

Lee, G.R. Megaloblastic and nonmegaloblastic macrocytic anemias. In: G.R. Lee, T.C. Bithell, J. Foerster, J.W. Athens, J.N. Lukens (Ed.) Wintrobe’s Clinical Hematology. Philadelphia: 1993, pp. 745-807.

Rabhi S, Maaroufi M, Khibri H, Belahsen F, Tizniti S, Berrady R, Bono W. Magnetic resonance imaging findings within the posterior and lateral columns of the spinal cord extended from the medulla oblongata to the thoracic spine in a woman with subacute combined degeneration without hematologic disorders: a case report and review of the literature. J Med Case Reports 2011; 5:166.

Asano M. Subacute combined degeneration with liner high intensity lesion of columns on MRI. No To Shinkei 2001; 53): 1068- 9.

Russell JSR, Batten FE, Collier J. Subacute combined degeneration of the spinal cord. Brain 1900; 23: 39–110.

Mancall EL. Nutritional disorders of the nervous system. In: Aminoff MJ ed. Neurology and General Medicine. Philedelphia, PA: Churchill Livingstone; 2001: 277-316.

İyigün İ, Yılmaz N.Y, Kaya H, Subacute Combined Degeneration of Spinal Cord Caused by Vitamin B12 Deficiency, AÜTF 1999; 31: 45-7.

Iwanami H, Tanaka M, Iwakawa H, Takiguti Y, Inukai T. A case presenting with ataxic gait and dementia due to vitamin B 12 deficiency without megaloblastic anemia or subacute combined degeneration of the spinal cord. Brain Nevre 2011; 63: 267- 9.

Katsaros VK, Glocker FX, Hemmer B, Schumacher M. MRI of spinal cord and brain lesions in subacute combined degeneration. Neuroradiology 1998; 40: 716- 9.

Healton, E.B.; Savage, D.G. Neurologic aspects of cobalamin deficiency. Medicine Baltimore 1991; 70: 229–45.

KohMorishita A, Tomita H, Takaishi Y, Nishihara ME. A case of subacute combined degeneration of the spinal cord diagnosed by characteristic findings of magnetic resonance imaging: case report and review of 22 cases. No Shinkei Geka 2005; 33: 489- 95.

Özdemir HS. The importance of vitanins and minerales in human health. Türkiye klinikleri J int med. Sci 2006; 2: 1-7.

Adams and Victor’s, Multipl Skleroz Principles of Neurology. 9.baskı (Çev.Ed: Emre M), Sinir Sisteminin Beslenme Yetersizliğine Bağlı Dejeneratif Hastalıkları, Güneş Kitapevi, İstanbul, 2008 say; 1117-21.

Dali-Youcef, N.; Andres, E. An update on cobalamin deficiency in adults. QJM 2009;102: 17–28.

Vasconcelos OM, Poehm EH, McCarter RJ, Campbell WW, Quezado ZM. Potential outcome factors in subacute combined degeneration review of observational studies. J Gen Intern Med 2006;21:1063-8.

Karantanas AH, Markonis A, Bisbiyiannis G. Subacute combined degeneration of the spinal cord with involvement of the anterior columns: a new MRI finding. Neuroradiology 2000;42:115-7.

Puri V, Chaudhry N, Goel S, Gulati P, Nehru R, Chowdhury D. Vitamin B12 deficiency: A clinical and electrophysiological profile. Electromyogr. Clin. Neurophysiol. 2005; 45: 273–84.

Hemmer B, Glocker FX, Schumacher M, Deuschl G, Lucking CH.Subacute combined degeneration: clinical, electrophysiological, and magnetic resonance imaging findings. J Neurol Neurosurg Psychiatry 1998;65:822-7.

Yamada K, Shrier DA, Tanaka H, Numaguchi Y. A case of subacute combined degeneration: MRI findings. Neuroradiology 1998;40:398-400.

Işıkay C, Tuncel D, Selçuki D, Mutluer N, Güngör L.Nöroanemik sendrom; 21 hastanın klinik, laboratuar ve elektrofizyolojik değerlendirmesi. Ankara Üniversitesi Tıp Fakültesi Mecmuası 2000;53:109-12.

Masson C, Colombani JM, Dehen H. Magnetic resonance imaging of subacute myelopathy due to cobalamin deficiency. Eur J Neurol 1998;5:99-101.

Penas M, Blanco A, Villarejo A, Juntas R, Miranda P, Martinez A. Subacute combined degeneration of the spinal cord: MR findings. Neurologia 2002;17:447-8.

Locatelli ER, Laureno R, Ballard P, Mark AS. MRI in vitamin B12 deficiency myelopathy. Can J Neurol Sci 1999;26:60-3.

Wolansky LJ, Goldstein G, Gozo A, Lee HJ, Sills I, Chatkupt S. Subacute combined degeneration of the spinal cord: MRI detection of preferential involvement of the posterior columns in a child. Pediatr Radiol 1995;25:140-1.

Berlit P, Ringelstein A, Liebig T. Spinal MRI precedes clinical improvement in subacute combined degeneration with B12 deficiency, Neurology 2004;63:592.

Tajima Y, Mito Y, Owada Y, Moriwaka F, Tashiro K. MR appearance of subacute combined degeneration of the spinal cord. J Psychiatry Neurol 1994; 48: 611- 4.

Sayın B, Boyacıgil S, Gülhan S, Yüksel E. Anassesment of clinical findings and servical spinal magnetic resonance imaging in patient with multiple sclerosis. J Med Sci 2005; 25:58- 64.

Terzi M, Terzi T, Tander B, Cantürk F, Onar M. Radikülopati kliniğini taklit eden subakut kombine dejenerasyon: iki olgu sunumu. Türk Fiz Rehab Derg 2008;54:174-6.

Murata S, Naritomi H, Sawada T. MRI in subacute combined degeneration. Neuroradiology 1994;36:408- 9.

Tartaglino LM, Flanders AE, Rapoport RJ. Intramedullary causes of myelopathy. Semin Ultrasound CT MR1994;15:158-88.

Kyröläinen H, Avela J, McBride JM, et al. Effects of power training on muscle structure and neuromuscular performance. Scand J Med Sci Sports 2005;15:58-64.

Wingerchuk, DM. Neuromyelitis optica. The International MS Journal 2006;13: 42–50.

Chalumeau-Lemoine L, Chretien F, Gaelle Si Larbi A, Brugieres P, Gray F, Brun-Buisson C, Creange A. Devic disease with brainstem lesions. Arch Neurol, 2006, 63: 591-3.

Filippi M, Rocca M.A, Moiola L, et al.: MRI and magnetization transfer imaging changes in the brain and cervical cord of patients with Devic’s neuromyelitis optica. Neurology, 1999, 53: 1705-10.

Pandey S, Kalita J, Misra UK. A sequential study of visual evoked potential in patients with vitamin B12 deficiency neurological syndrome, Clin Neurophysiol. 2004;115:914-8.

Huang C.R, Chang W.N, Tsai N.W, Lu C.H. Serial nerve conduction studies in vitamin B12 deficiency-associated polyneuropathy. Neurol. Sci. 2011; 32: 183–6.

Goebels, N, Soyka M. Dementia associated with vitamin B(12) deficiency: Presentation of two cases and review of the literature. J. Neuropsychiatry Clin. Neurosci. 2000; 12: 389–94.

Peter B, Adrian R, Thomas L. Spinal MRI precedes clinical improvement in subacute combined degeneration with B12 deficiency. Neurology 2004; 63: 592.

Ravina B, Loevner L, Bank W. MR findings in subacute combined degeneration of the spinal cord: A case of reversible cervical myelopathy. AJR 2000; 174: 863- 5.

Terzi M, Yazıcı D, Yazıcı T, Onar M. Spinal Görüntüleme Bulgusu Olan ve Subakut Kombine Dejenerasyon Tanısı Alan Sekiz Hastanın Klinik, Demografik ve Radyolojik Özellikleri, Ondokuz Mayıs Üniversitesi, Nöroloji, Samsun, Türkiye, Journal of Neurological Sciences [Turkish] 2011, 28: 29; 552-62.

Dr David Clopton and Dr Frank Gaillard et al., Subacute combined degeneration of the cord (SCD) is caused by a vitamin B12deficiency, Erişim tarihi: 8 Mayıs 20014. Available from: http://radiopaedia.org/articles/sub-acute-combined-degeneration-of-the-cord.

Anitha Sen, Kesavadas Chandrasekhar, Spinal MR imaging in Vitamin B12 deficiency: Case series; differential diagnosis of symmetrical posterior spinal cord lesions, Annals of Indian Aacedemy of Neurolgy 2013; 16:255-8.

Published
2016-01-10
Section
Literature Review With Cases