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Vitamin B12 deficiency presenting as acute febrile encephalopathy and retinopathy

Dongre, Nikhil ; Singh, Varun Kumar ; Kalita, Jayantee ; Misra, Usha Kant

Postgraduate medical journal, 2021-03, Vol.97 (1145), p.141-142 [Periódico revisado por pares]

England: Oxford University Press

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  • Título:
    Vitamin B12 deficiency presenting as acute febrile encephalopathy and retinopathy
  • Autor: Dongre, Nikhil ; Singh, Varun Kumar ; Kalita, Jayantee ; Misra, Usha Kant
  • Assuntos: Alzheimer's disease ; Anemia ; Dementia ; Diarrhea ; Encephalitis ; Epidermal growth factor ; Fever ; Patients ; Spinal cord ; TNF inhibitors ; Typhus
  • É parte de: Postgraduate medical journal, 2021-03, Vol.97 (1145), p.141-142
  • Notas: ObjectType-Case Study-2
    SourceType-Scholarly Journals-1
    ObjectType-Feature-4
    content type line 23
    ObjectType-Report-1
    ObjectType-Article-3
  • Descrição: Correspondence to Professor Usha Kant Misra, Neurology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh 226014, India; drukmisra@rediffmail.com Introduction Vitamin B12 deficiency causes macrocytic anaemia, peripheral neuropathy, myelin loss in posterior and lateral columns of spinal cord (subacute combined degeneration of cord) and a wide variety of neuropsychiatric symptoms in adults.1 In neonates and children, vitamin B12 deficiency manifests with developmental delay, regression of milestones, seizures, encephalopathy and involuntary movements.2 We report a patient with vitamin B12 deficiency who presented with acute febrile illness. Fever can occur in megaloblastic anaemia in 40% of patients.4 Retinopathy in megaloblastic anaemia especially in those with severe anaemia and thrombocytopaenia is more likely to have retinal haemorrhages.5 6 Vitamin B12 deficiency down-regulates epidermal growth factor while up-regulates tumour necrosis factor alpha levels which are responsible for developing encephalopathy, and these changes are reversible with the supplementation of vitamin B12.7 From this case, it can be concluded that in patients with fever, altered sensorium, involvement of joint position and vibration sense should alert for the possibility of vitamin B12 deficiency, which is easy to confirm and responds well to B12 supplementation. Plasma levels of vitamin B12, epidermal growth factor and tumor necrosis factor alpha in patients with Alzheimer dementia.
  • Editor: England: Oxford University Press
  • Idioma: Inglês
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