老年人维生素B12缺乏引起的神经病变和认知和运动障碍:一个案例研究
Marieke J H J Dekker1, Gonneke C Heerdink1, Clara H M Plattel1
1B12 Institute, Rotterdam, the Netherlands.
Food and nutrition bulletin
|July 10, 2024
概括
老年患者的维生素B12缺乏症往往表现为神经和认知症状,由于衰老或其他疾病而容易错过. 早期诊断和用氧巴胺注射的治疗显著改善了患者的治疗结果.
科学领域:
- 老年病的医生 老年病的医生
- 神经学 神经学
- 内分泌学 在内分泌学.
背景情况:
- 维生素B12缺乏会导致各种神经和认知症状,在老年人中经常被忽视.
- 症状可能被错误地归因于衰老或并发症,延迟诊断.
研究的目的:
- 强调怀疑老年患者出现神经和认知症状的维生素B12缺乏的重要性.
- 为了说明缺乏病例的诊断挑战,包括正常的维生素B12水平.
主要方法:
- 两名老年患者 (71岁男性,74岁女性) 患有维生素B12缺乏症的案例研究.
- 审查患者病史,症状,诊断测试 (包括B12,同型半素,甲基马龙酸) 和治疗反应.
主要成果:
- 两位患者都表现出严重的疲劳,认知障碍和步态障碍.
- 由于先前的治疗,一个患者的B12水平正常至高;另一个患者的水平正常,由高水平的同类半氨酸和甲基马龙酸证实.
- 用氧巴胺注射治疗导致认知,情绪和运动功能的显著改善.
结论:
- 高水平的临床怀疑维生素B12缺乏症指数对于有神经/认知症状的老年患者至关重要,即使维生素B12水平正常.
- 胃肠道手术或家族病史等危险因素需要进行彻底的调查.
- 及时诊断和用氧巴胺治疗对于功能恢复至关重要.
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