HLA phenotype A2;B12 in vitamin B12 neuromyelopathy

Severe neurological complications (either peripheral neuropathy, subacute combined degeneration of the cord or cerebral changes) are a characteristic feature in some patients with marked vitamin B12 deficiency. Although Addisonian pernicious anaemia (PA) is the major cause of this neurological syndrome, the disorder has been described in association with other conditions in which there is a profound depletion of vitamin B12 stores. Sixteen patients with vitamin B12 neuromyelopathy, associated with PA, have been HLA-typed for 27 alleles of the A and B loci and compared with 53 cases of PA without neurological damage and 60 controls of the same ethnic group. There is a significantly increased frequency of the HLA phenotype. A12;B12 (44% instead of 4% in PA patients without neurological damage) in the disease group studied (P less than 0.0005). The signficance of these findings in relation to the pathogenesis of vitamin B12 neuromyelopathy is discussed.