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Vitamin B12-responsive neuropathies: A case series.
1a Section of Palliative Care, Department of Medicine , Yale University School of Medicine and Smilow Cancer Hospital , New Haven , CT , USA.
Vitamin B12 responsive neuropathies are common and can occur even without deficiency. These neuropathies are linked to oxidative stress, suggesting B12 may benefit patients with normal B12 levels.
Area of Science:
- Neurology
- Metabolic Medicine
- Nutritional Neuroscience
Background:
- Vitamin B12 deficiency frequently causes neuropathies.
- Vitamin B12 possesses antioxidant and neurotrophic properties, suggesting potential therapeutic roles beyond deficiency states.
- Oxidative stress is implicated in various neuropathies.
Purpose of the Study:
- To investigate the characteristics of vitamin B12-responsive neuropathies.
- To identify predictors of vitamin B12 response in neurological conditions.
- To explore the association between B12-responsive neuropathies and oxidative stress markers.
Main Methods:
- Retrospective analysis of 78 patients with neurological abnormalities treated with vitamin B12.
- Evaluation included measurements of vitamin B12, methylmalonic acid (MMA), and homocysteine.
- Assessment of neurological improvement and presence of oxidative stress risks.
Main Results:
- 83% of subjects showed neurological improvement with vitamin B12 therapy.
- Many responders had normal pre-therapy B12, MMA, and homocysteine levels.
- B12 responsiveness was associated with oxidative stress risks, especially in those with normal B12 levels.
Conclusions:
- Vitamin B12-responsive neuropathies are prevalent and not solely dependent on hematological or metabolic markers of deficiency.
- Oxidative stress appears linked to B12-responsive neuropathies, even with normal B12 levels.
- Empirical trials of parenteral vitamin B12 are recommended due to a lack of clear predictive markers for response.
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