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Neurological manifestations of B(12) deficiency with emphasis on its aetiology

Pradeep G Divate, Rashida Patanwala

    The Journal of the Association of Physicians of India
    |December 3, 2014
    PubMed

    Insights

    Pernicious anaemia (PA) is a significant cause of Vitamin B12 deficiency and neurological issues in Indian adults over 40. Autoimmune markers like anti-parietal cell antibodies (APCAB) and anti-intrinsic factor antibodies (AIFAB) are common in these patients.

    Area of Science:

    • Neurology
    • Gastroenterology
    • Immunology

    Background:

    • Pernicious anaemia (PA) is traditionally considered more prevalent in Western populations.
    • This study investigates the role of PA as a cause of Vitamin B12 deficiency in Indian patients with neurological disease.

    Purpose of the Study:

    • To identify etiological factors for Vitamin B12 deficiency in patients presenting with subacute combined degeneration (SACD) and other neurological symptoms.
    • To assess the prevalence and significance of PA in this demographic.

    Main Methods:

    • A prospective study involving 50 patients clinically suspected of Vitamin B12 deficiency.
    • Comprehensive clinical, hematological, biochemical, and radiological investigations were performed.

    Main Results:

    • The study population comprised predominantly males (41/50) over 40 years of age.
    • No correlation was found between socio-economic/dietary status and clinical presentation.
    • Anti-intrinsic factor antibodies (AIFAB) were positive in 38% and anti-parietal cell antibodies (APCAB) in 56% of patients.

    Conclusions:

    • Pernicious anaemia is a key cause of neurological manifestations, including SACD, in Vitamin B12 deficient individuals over 40 in India.
    • The presence of AIFAB or APCAB supports the diagnosis of PA in this population, regardless of socio-economic or dietary factors.
    Abstract

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