Autoimmune gastritis concomitant with gastric adenoma and subacute combined degeneration of the spinal cord

2021 ◽  
Vol 14 (5) ◽  
pp. e242836
Author(s):  
Masahiro Taniguchi ◽  
Gota Sudo ◽  
Yuzufumi Sekiguchi ◽  
Hiroshi Nakase
Keyword(s):  
Spinal Cord ◽  
Histopathological Examination ◽  
Intrinsic Factor ◽  
Pernicious Anaemia ◽  
Autoimmune Gastritis ◽  
Gastric Neoplasms ◽  
Gastric Body ◽  
Vitamin B ◽  
Gastric Adenoma ◽  
Subacute Combined Degeneration

A 62-year-old woman was referred to our department for further investigation of anaemia. Blood test showed macrocytic anaemia. Oesophagogastroduodenoscopy (OGD) revealed proximal-predominant gastric atrophy and flat elevated lesion in the gastric body. Several days after OGD, she complained of gait disturbance and was diagnosed with subacute combined degeneration of the spinal cord. Furthermore, laboratory tests showed positive for both anti-parietal cell and anti-intrinsic factor antibodies, as well as increased serum gastrin level and decreased pepsinogen I level, which confirmed the diagnosis of autoimmune gastritis (AIG). Anaemia and neurological symptoms were improved after vitamin B12 supplementation. Subsequently, the patient underwent gastric endoscopic submucosal dissection; histopathological examination revealed gastric adenoma. AIG can cause gastric neoplasms and vitamin B12 deficiency, with the latter resulting in pernicious anaemia and neurological disorders. These diseases are treatable but potentially life-threatening. This case highlights the importance of early diagnosis of AIG and proper management of its comorbidities.

Nitrous Oxide Abuse‐Induced Subacute Combined Degeneration: Classic Neuroimaging Findings on MRI

Neurographics ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 72-74
Author(s):  
A.K. Kirsch ◽  
S.M. Allison ◽  
S.A. Kilanowski
Keyword(s):  
Spinal Cord ◽  
Nitrous Oxide ◽  
Mr Imaging ◽  
Young Patient ◽  
Patient Population ◽  
High Signal ◽  
Vitamin B ◽  
Subacute Combined Degeneration ◽  
Dorsal Columns ◽  
Delay In Treatment

Subacute combined degeneration is uncommonly a result of nitrous oxide abuse and presents with high signal in the dorsal columns of the spinal cord on T2-weighted MR imaging. We present a case of subacute combined degeneration in a young patient who abused nitrous oxide, which is an uncommon cause and infrequently seen in this patient population. Symptoms are often reversible with treatment of vitamin B12, and radiologists should be aware of these findings to avoid delay in treatment.

scholarly journals Helicobacter pylori associated vitamin B12 deficiency, pernicious anaemia and subacute combined degeneration of the spinal cord

2013 ◽  
Vol 2013 (sep29 1) ◽  
pp. bcr2013200380-bcr2013200380 ◽  
Author(s):  
H. B. Gowdappa ◽  
M. Mahesh ◽  
K. V. K. S. N. Murthy ◽  
M. G. Narahari
Keyword(s):  
Spinal Cord ◽  
Helicobacter Pylori ◽  
Vitamin B12 ◽  
Vitamin B12 Deficiency ◽  
Pernicious Anaemia ◽  
Subacute Combined Degeneration ◽  
B12 Deficiency

scholarly journals A Case of Sub-acute Combined Degeneration of the Spinal Cord with Associated Pernicious Anaemia

Pulse ◽  
2014 ◽  
Vol 5 (1) ◽  
pp. 57-60 ◽  
Author(s):  
AA Bhuiyan ◽  
SK Dash ◽  
SMH Shahriar ◽  
F Nahid ◽  
S Arefin
Keyword(s):  
Spinal Cord ◽  
Vitamin B12 ◽  
Intrinsic Factor ◽  
Vitamin B12 Deficiency ◽  
Pernicious Anaemia ◽  
Bone Marrow Examination ◽  
Chronic Atrophic Gastritis ◽  
Endoscopic Biopsy ◽  
B12 Deficiency ◽  
Hands And Feet

Aim and Objective Vitamin B12 deficiency disease, specially associated with pernicious anaemia is a relatively rare disease in the developing countries. Patients with B12 deficiency may present with hematological, gastro-intestinal and neuro-psychiatric manifestations. Here we discuss a case of a fifty five-year-old lady presented with sub-acute combined degeneration of the spinal cord. Case presentation A fifty five year old female was admitted in Neurology ward in Apollo Hospitals, Dhaka from OPD for progressive quadriparesis with tingling in the hands and feet. She had no associated visual, bulbar symptoms, sphincter incontinence or memory impairment. Investigation revealed mild anaemia, macrocytosis on peripheral blood picture, low Vitamin B12 level with megaloblastic changes in bone marrow examination. Anti-Intrinsic factor antibody and anti-parietal cell antibody was not done, as it is not available here. MRI of dorsal spine shows T2 hyper-intense lesions in the posterior cord. GI Endoscopic biopsy revealed chronic atrophic gastritis. Conclusion We presented this case because of its relatively uncommon occurrence in our country. Sub-acute combined degeneration of spinal cord associated with dietary deficiency is common in Indian sub-continent. High index of suspicion is needed for its early diagnosis as delay in treatment can lead to poor neurological recovery. DOI: http://dx.doi.org/10.3329/pulse.v5i1.20193 Pulse Vol.5 January 2011 p.57-60

Plasma Radioactivity following Oral Administration of 57Co-Labelled Vitamin B12

1968 ◽  
Vol 13 (12) ◽  
pp. 425-429 ◽  
Author(s):  
R. D. Finney ◽  
R. W. Payne
Keyword(s):  
Intrinsic Factor ◽  
Pernicious Anaemia ◽  
Test Dose ◽  
Normal Subjects ◽  
Vitamin B ◽  
Oral Test ◽  
Parenteral Dose ◽  
Schilling Test ◽  
Low Levels ◽  
Gastro Intestinal Tract

Levels of plasma radioactivity were measured 8 1/2 hours after an oral dose of 1 μg of 57Co-labelled vitamin B12. The oral test dose was followed after 2 hours by a large parenteral dose (1,000 μg) of non-radioactive vitamin B12. The results of this test have been compared with the results of the urinary excretion (Schilling test) in 14 normal subjects and in 14 patients suffering from pernicious anaemia (in 10 of whom the test was later repeated with added hog intrinsic factor). Very low levels of plasma radioactivity were found in patients suffering from pernicious anaemia (less than 0.21% of the administered dose per litre of plasma); much higher levels of radioactivity (more than 0.95% of administered radioactivity per litre of plasma) were found in normal subjects. Levels of plasma radioactivity approaching but not quite reaching the normal range were found in patients with pernicious anaemia when the test was repeated with the addition of hog intrinsic factor. It is concluded that this test provides a simple, rapid, semi-quantitative method of assessing the absorption of vitamin B12 from the gastro-intestinal tract. In our view, it is likely to supplant the Schilling test for routine use in a busy general hospital.

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