DEGENERACIÓN COMBINADA SUBAGUDA, ANEMIA MEGALOBLÁSTICA Y MANIFESTACIONES NEUROPSIQUIÁTRICAS Caracterización clínica de catorce casos con deficiencia de cianocobalamina
Palabras clave:
Anemia, astenia, apalestesia, Romberg, degeneración combinada subaguda, vitamina B12, weakness, apalesthesia, subacute combined degeneration, Vitamin B12Resumen
RESUMENLa degeneración combinada subaguda es un desorden neurológico que afecta los cordones posteriores de la médula y se manifiesta precozmente con disestesia, parestesias y astenia severa. En pacientes de riesgo, es la manifestación inicial (y a veces única) de una deficiencia de vitamina B12. El cerebro, el nervio óptico y los nervios periféricos pueden afectarse igualmente.
Presentamos catorce casos de degeneración combinada subaguda por deficiencia de vitamina B12, con niveles bajos y anemia en la mayor parte de pacientes. Una revisión de la literatura muestra también estados carenciales en grupos poblacionales pobres de adultos mayores con otros factores de riesgo; y deficiencias subclínicas con depósitos hepáticos de vitamina B12 casi exhaustos.
Puede haber clínica neuropsiquiátrica en casos sin niveles bajos de vitamina B12 ni anemia.
Palabras clave: Anemia, astenia, apalestesia, Romberg, degeneración combinada subaguda, vitamina B12.
SUBACUTE COMBINED DEGENERATION, MEGALOBLASTIC ANEMIA AND NEUROPSYCHIATRIC MANIFESTATIONSClinical picture of fourteen cases with deficiency of cianocobalaminABSTRACTSubacute combined degeneration is a neurologic condition that involves spinal cord posterior columns, presenting early with disesthesia, paresthesia and severe asthenia. In patients at risk, it is the first (and sometimes the only) manifestation of a vitamin B12 deficiency. Brain, optic and peripheral nerves may
be equally involved.
We report fourteen cases of subacute combined degeneration and vitamin B12 deficiency as shown by low levels and megaloblastic anemia in most cases. A review of the literature was undertaken, remarking the importance of nutritional deficiencies seen in impoverished elderly people with additional risk factors; subclinical cases with
liver storages almost exhausted. There could be a neuropsychiatric picture even without anemia o low vitamin B12 levels.
Key words: Anemia, weakness, apalesthesia, Romberg, subacute combined degeneration, Vitamin B12.
Biografía del autor/a
Tomás Omar Zamora Bastidas, Universidad del Cauca
Carlos Echavarría Betancourt, Universidad del Cauca
Nancy Yannette Hurtado Ordóñez, Universidad del Cauca
Edward Ruiz Salazar, Universidad del Cauca
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