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MRI findings in cobalamin deficiency
Kavita K Krishna1, Abou-Sharbin Maher Arafat, Nasli Rustom Ichaporia
1Department of Medicine, Bharati Vidyapeeth's Deemed University Medical College, Dhankawadi, Pune 411043, India. ourdoctor@doctor.com
Summary
A jejuno-iliectomy can lead to vitamin B12 and folate deficiency, causing neurological symptoms like limb weakness and walking difficulties. Spinal cord MRI may reveal characteristic changes in these cases.
Area of Science:
- Neurology
- Gastroenterology
- Nutritional Science
Background:
- Malabsorption after extensive intestinal resection, such as jejuno-ileectomy, can lead to specific nutrient deficiencies.
- Vitamin B12 and folate are crucial for neurological function and DNA synthesis.
Observation:
- A 55-year-old male presented with progressive neurological deficits including limb weakness, paresthesias, and gait disturbance.
- Clinical findings included a loss of posterior column sensations, suggesting dorsal spinal cord involvement.
- Magnetic Resonance Imaging (MRI) of the spine revealed a T2 hyperintense band in the dorsal spinal cord.
Findings:
- Laboratory investigations indicated deficiencies in vitamin B12 and folate.
- The clinical presentation and MRI findings correlated with the identified nutritional deficiencies.
Implications:
- This case highlights the importance of monitoring vitamin B12 and folate levels in patients with a history of jejuno-ileectomy.
- Early diagnosis and supplementation can prevent or mitigate potentially irreversible neurological damage.
- Understanding the link between gastrointestinal surgery, malabsorption, and neurological complications is crucial for patient management.