Type:
Educational Exhibit
Keywords:
Metabolic disorders, Diagnostic procedure, MR, Neuroradiology spine, Neuroradiology peripheral nerve, Neuroradiology brain
Authors:
S. Benítez Rivero, Y. El Khatib Ghzal, V. Pantoja Ortiz, D. Eiroa, V. Martin Garcia, M. Fdez. del Castillo Ascanio, C. A. Marichal Hernández; Santa Cruz de Tenerife/ES
DOI:
10.26044/ecr2019/C-2127
Background
Vitamin B12 or cobalamin is produced by bacteria in the large bowel of humans and by external bacteria and fungi.
However,
cobalamin from the former source is not absorbed,
and humans need to introduce it solely from the diet.
The major sources of cobalamin are animal proteins.
There are many conditions in which vitamin B12 deficieny may develop.
Their aetiology can be divided into three main categories: inadequate intake (vegetarians),
malabsorption; and other conditions (nitrous oxide anaesthesia,
transcobalamin II deficiency),
malabsorption being the most important.
The most common cause of malabsorption is pernicious anaemia,
followed by gastrectomy,
intestinal infections and ileal abnormalities (tropical sprue).
Vitamin B12 deficiency causes a wide range of hematological,
gastrointestinal,
psychiatric and neurological disorders.
Megaloblastic anemia is a common early symptom leading to the diagnosis,
although neurological symptoms may occur in the absence of hematological abnormalities.
The neurological manifestations are the most worrying,
because they often fail to remit completely on treatment.
In this exhibit we will focus in the neurological manifestations in cobalamine deficiency with radiological expression.