Nutrients 2013, 5(11), 4521-4539; doi:10.3390/nu5114521
Review

Cobalamin Deficiency: Clinical Picture and Radiological Findings

Received: 22 September 2013; in revised form: 18 October 2013 / Accepted: 28 October 2013 / Published: 15 November 2013
(This article belongs to the Special Issue Vitamin B12 and Human Health)
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract: Vitamin B12 deficiency causes a wide range of hematological, gastrointestinal, psychiatric and neurological disorders. Hematological presentation of cobalamin deficiency ranges from the incidental increase of mean corpuscular volume and neutrophil hypersegmentation to symptoms due to severe anemia, such as angor, dyspnea on exertion, fatigue or symptoms related to congestive heart failure, such as ankle edema, orthopnea and nocturia. Neuropsychiatric symptoms may precede hematologic signs and are represented by myelopathy, neuropathy, dementia and, less often, optic nerve atrophy. The spinal cord manifestation, subacute combined degeneration (SCD), is characterized by symmetric dysesthesia, disturbance of position sense and spastic paraparesis or tetraparesis. The most consistent MRI finding is a symmetrical abnormally increased T2 signal intensity confined to posterior or posterior and lateral columns in the cervical and thoracic spinal cord. Isolated peripheral neuropathy is less frequent, but likely overlooked. Vitamin B12 deficiency has been correlated negatively with cognitive functioning in healthy elderly subjects. Symptoms include slow mentation, memory impairment, attention deficits and dementia. Optic neuropathy occurs occasionally in adult patient. It is characterized by symmetric, painless and progressive visual loss. Parenteral replacement therapy should be started soon after the vitamin deficiency has been established.
Keywords: vitamin B12; cobalamin; neuropathy; subacute combined degeneration; neuroimaging
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MDPI and ACS Style

Briani, C.; Dalla Torre, C.; Citton, V.; Manara, R.; Pompanin, S.; Binotto, G.; Adami, F. Cobalamin Deficiency: Clinical Picture and Radiological Findings. Nutrients 2013, 5, 4521-4539.

AMA Style

Briani C, Dalla Torre C, Citton V, Manara R, Pompanin S, Binotto G, Adami F. Cobalamin Deficiency: Clinical Picture and Radiological Findings. Nutrients. 2013; 5(11):4521-4539.

Chicago/Turabian Style

Briani, Chiara; Dalla Torre, Chiara; Citton, Valentina; Manara, Renzo; Pompanin, Sara; Binotto, Gianni; Adami, Fausto. 2013. "Cobalamin Deficiency: Clinical Picture and Radiological Findings." Nutrients 5, no. 11: 4521-4539.

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