China
Africa
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Case 1
Published in Andrew Solomon, Julia Anstey, Liora Wittner, Priti Dutta, Clinical Cases, 2021
Andrew Solomon, Julia Anstey, Liora Wittner, Priti Dutta
This may suggest that he is developing multiple sclerosis; however, it can also be seen in a number of other neurological disorders including transverse myelitis, vitamin B12 deficiency (subacute combined degeneration of spinal cord) and compression of the cervical spinal cord among others
Common/useful drugs
Published in Jonathan P Rogers, Cheryl CY Leung, Timothy RJ Nicholson, Pocket Prescriber Psychiatry, 2019
Jonathan P Rogers, Cheryl CY Leung, Timothy RJ Nicholson
Caution: undiagnosed megaloblastic ↓Hb (i.e. ↓B12, as found in pernicious anaemia) – never give alone if B12deficiency, as can precipitate subacute combined degeneration of spinal cord.
Should we follow the guidelines on vitamin B12 deficiency and diabetes? A retrospective analysis of data from middle eastern population
Published in Alexandria Journal of Medicine, 2023
Ahmed Kamal Swidan, Marwa Ahmed Salah Ahmed
The physiological effects of vitamin B12 are mediated by two enzymatic mechanisms, the conversion of succinyl-CoA from methyl malonyl-Coenzyme A (CoA) and the methylation process that turns homocysteine into methionine. As a co-factor, vitamin B12 helps homocysteine be methylated into methionine, that is transformed to S adenosylmethionine. A lack of vitamin B12 impairs this conversion pathway, which raises levels of methylmalonic acid (MMA). Following this, neuronal membranes’ fatty acid secretion is compromised [5]. Additionally is vitamin B12 necessary for the creation of monoamines, or neurotransmitters like serotonin and dopamine [6]. Previously mentioned factors together account for the neurocognitive or mental symptoms that follow vitamin B12 insufficiency. Axonal demyelination and eventually death are hallmarks of vitamin B12 deficiency-induced neuronal injury, which presents as peripheral or autonomic neuropathy, subacute combined degeneration of spinal cord, delirium and dementia [5–7].