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Related Concept Videos

Fatigue01:21

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Fatigue occurs when materials rupture under repeated or fluctuating loads, even at stress levels far below their static breaking strength. It typically results in brittle failure, even for ductile materials. It is a critical consideration in designing machines and structural components subjected to repetitive or varying loads. The nature of these loadings can range from fluctuating loads like unbalanced pump impellers causing vibrations to repeatedly bending a thin steel rod wire back and forth...
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A Veteran Presenting With Fatigue and Weakness.

Lindsey Ulin1,2, Meghan Hickey2,3, Caroline Ross2,3

  • 1Brigham and Women's Hospital, Boston, Massachusetts.

Federal Practitioner : for the Health Care Professionals of the VA, Dod, and PHS
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Summary
This summary is machine-generated.

A 65-year-old male veteran experienced progressive neurological symptoms and anemia. Investigations revealed a vitamin B12 deficiency, likely due to autoimmune gastritis, presenting as a rare cause of pancytopenia and neurological deficits.

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Area of Science:

  • Internal Medicine
  • Hematology
  • Neurology

Background:

  • Vitamin B12 deficiency can cause significant hematological and neurological abnormalities.
  • Autoimmune gastritis is a known, albeit less common, cause of vitamin B12 deficiency.

Purpose of the Study:

  • To report a case of a 65-year-old male veteran with progressive neurological symptoms and anemia.
  • To highlight vitamin B12 deficiency secondary to autoimmune gastritis as a rare cause of pancytopenia and neurological deficits.

Main Methods:

  • Detailed patient history and physical examination.
  • Comprehensive laboratory investigations including complete blood count, peripheral blood smear, and vitamin B12 levels.
  • Imaging studies such as abdominal ultrasound.

Main Results:

  • The patient presented with fatigue, dyspnea, numbness, and cognitive impairment.
  • Laboratory findings revealed pancytopenia (low red blood cells, white blood cells, and platelets) and low vitamin B12 levels.
  • Peripheral blood smear showed characteristic signs of megaloblastic anemia.
  • Abdominal ultrasound identified a hepatic mass, though its relation to the primary presentation was unclear.

Conclusions:

  • Vitamin B12 deficiency, particularly when caused by autoimmune gastritis, can manifest with severe hematological and neurological symptoms.
  • This case underscores the importance of considering nutritional deficiencies in the differential diagnosis of unexplained anemia and neurological deficits.
  • Prompt diagnosis and treatment of vitamin B12 deficiency are crucial for reversing these potentially debilitating effects.