01 February 2006
Vitamin B12 deficiency can mimic multiple sclerosis – report of two cases
Iwona Kurkowska-Jastrzębska, Wojciech Wicha, Anna CzłonkowskaCase Rep Clin Pract Rev 2006; 7:64-68 :: ID: 449522
Abstract
Background: Because of heterogeneous manifestations of MS, an incorrect diagnosis is not uncommon. Tests
supporting the diagnosis of MS, including magnetic resonance imaging (MRI), cerebrospinal fluid (CSF) examination and evoked potentials help to make diagnosis as early as possible. One of the diseases that is usually considered in differential diagnosis of MS is vitamin B12 deficiency. Differential diagnosis however may be difficult because neurological and hematological disorder may develop independently and with various intensity, pernicious anemia may respond to steroid therapy, MRI findings in vitamin B12 deficiency may be similar to that in MS and MS may coexist with low vitamin B12 level. Here, we present two cases of Vitamin B12 deficiency
in young women that was misdiagnosed as MS.
Case Report: In both cases besides the neurological symptoms of gait disturbances and paresthesia, MR
scan showed high signal of T2-weighted imaging lesions periventricular and affecting corpus callosum. In one case, oligoclonal bands were positive in CSF examination. Both patients were
diagnosed as MS and treated with high dose of methylprednisolone with no improvement. Since
the level of vitamin B12 was found lower in both cases, they were treated with intramuscular
injection of vitamin B12 and improved gradually. In both, macrocytic anemia was present but
independently of neurological symptoms.
Conclusions: However clinical features and MRI findings closely resembled signs of MS, low vitamin B12 level and good response to vitamin B12 supplementation allowed to establish diagnosis of vitamin B12 deficiency.
Keywords: cyanocobalamin, Multiple Sclerosis, subacute spinal cord degeneration
448
In Press
12 Feb 2024 : Case report
Erdheim-Chester Disease Occult on Radiographs and CT but Visible on MRI and PETAm J Case Rep In Press; DOI: 10.12659/AJCR.941169
12 Feb 2024 : Case report
Surgical Treatment of Spontaneous Superficial Temporal Artery Arteriovenous Malformation: A Case ReportAm J Case Rep In Press; DOI: 10.12659/AJCR.942839
13 Feb 2024 : Case report
Warfarin Woes: A Rare Case of Hemoperitoneum with Intramural Small Bowel HematomaAm J Case Rep In Press; DOI: 10.12659/AJCR.943519
13 Feb 2024 : Case report
Hemorrhagic Presentation in Primary Central Nervous System Lymphoma: A Case StudyAm J Case Rep In Press; DOI: 10.12659/AJCR.942951
Most Viewed Current Articles
07 Mar 2024 : Case report
Neurocysticercosis Presenting as Migraine in the United StatesDOI :10.12659/AJCR.943133
Am J Case Rep 2024; 25:e943133
10 Jan 2022 : Case report
A Report on the First 7 Sequential Patients Treated Within the C-Reactive Protein Apheresis in COVID (CACOV...DOI :10.12659/AJCR.935263
Am J Case Rep 2022; 23:e935263
19 Jul 2022 : Case report
Atlantoaxial Subluxation Secondary to SARS-CoV-2 Infection: A Rare Orthopedic Complication from COVID-19DOI :10.12659/AJCR.936128
Am J Case Rep 2022; 23:e936128
23 Feb 2022 : Case report
Penile Necrosis Associated with Local Intravenous Injection of CocaineDOI :10.12659/AJCR.935250
Am J Case Rep 2022; 23:e935250