비특이내시경 소견을 보인 환자에서 자가면역위염 시사 혈청 소견이 동반된 비타민B12 결핍 아급성 연합 변성
Subacute Combined Degeneration due to Vitamin B12 Deficiency with Serologic Evidence of Autoimmune Gastritis and Non-specific Endoscopic Findings
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Subacute combined degeneration (SCD) is a neurological complication of vitamin B12 deficiency, typically affecting the posterior and lateral spinal cord. We report a case of SCD presenting with sensory ataxia and macrocytic anemia, caused by autoimmune gastritis despite chronic gastritis without marked atrophy. The diagnosis was confirmed by spinal magnetic resonance imaging showing hyperintense lesions in the dorsal columns with an inverted V sign, elevated methylmalonic acid and homocysteine, and positive intrinsic factor antibodies. This case emphasizes the need to consider SCD in patients with compatible symptoms, even when gastrointestinal evaluations are inconclusive.
Abstract
Subacute combined degeneration (SCD) is a neurological complication of vitamin B12 deficiency, typically affecting the posterior and lateral spinal cord. We report a case of SCD presenting with sensory ataxia and macrocytic anemia, caused by autoimmune gastritis despite chronic gastritis without marked atrophy. The diagnosis was confirmed by spinal magnetic resonance imaging showing hyperintense lesions in the dorsal columns with an inverted V sign, elevated methylmalonic acid and homocysteine, and positive intrinsic factor antibodies. This case emphasizes the need to consider SCD in patients with compatible symptoms, even when gastrointestinal evaluations are inconclusive.