Syncope due to vitamin-B12 deficiency - case report

Area of Science:

• Neurology
• Endocrinology
• Cardiology

Background:

• Vitamin B12 deficiency can present with diverse neurological symptoms.
• Cardiac autonomic neuropathy (CAN) is a known complication of vitamin B12 deficiency.

Observation:

• An 83-year-old male with a history of extensive bowel resection presented with recurrent syncope.
• Investigations revealed severe vitamin B12 deficiency and bradycardia, with cardiac causes ruled out.
• Syncope episodes resolved following vitamin B12 supplementation.

Findings:

• This case highlights a rare presentation of syncope due to vitamin B12 deficiency-induced CAN, without hematologic abnormalities.
• Severe vitamin B12 deficiency was identified as the cause of cardiac autonomic dysfunction leading to bradycardia and syncope.

Implications:

• Patients with a history of bowel resection require regular monitoring for vitamin B12 deficiency.
• Early detection and treatment of vitamin B12 deficiency can prevent severe complications like syncope.
• This case underscores the importance of considering metabolic causes for unexplained syncope, particularly in at-risk populations.