Subacute Combined Degeneration of the Spinal Cord Caused by Autoimmune Gastritis

Kazuhiro Ota; Ryosuke Yamaguchi; Akihiro Tsukahara; Shinya Nishida; Taro Shigekiyo; Satoshi Harada; Yuichi Kojima; Toshihisa Takeuchi; Shigeki Arawaka; Kazuhide Higuchi

doi:10.2169/internalmedicine.4684-20

CASE REPORTS

Subacute Combined Degeneration of the Spinal Cord Caused by Autoimmune Gastritis

Kazuhiro Ota, Ryosuke Yamaguchi, Akihiro Tsukahara, Shinya Nishida, Taro Shigekiyo, Satoshi Harada, Yuichi Kojima, Toshihisa Takeuchi, Shigeki Arawaka, Kazuhide Higuchi

Author information

Kazuhiro Ota
Second Department of Internal Medicine, Osaka Medical College, Japan
Ryosuke Yamaguchi
Second Department of Internal Medicine, Osaka Medical College, Japan
Akihiro Tsukahara
Division of Neurology, Forth Department of Internal Medicine, Osaka Medical College, Japan
Shinya Nishida
Second Department of Internal Medicine, Osaka Medical College, Japan
Taro Shigekiyo
Division of Neurology, Forth Department of Internal Medicine, Osaka Medical College, Japan
Satoshi Harada
Second Department of Internal Medicine, Osaka Medical College, Japan
Yuichi Kojima
Second Department of Internal Medicine, Osaka Medical College, Japan
Toshihisa Takeuchi
Second Department of Internal Medicine, Osaka Medical College, Japan
Shigeki Arawaka
Division of Neurology, Forth Department of Internal Medicine, Osaka Medical College, Japan
Kazuhide Higuchi
Second Department of Internal Medicine, Osaka Medical College, Japan

Keywords: autoimmune gastritis, vitamin B₁₂ deficiency, subacute combined degeneration of spinal cord, peripheral neuropathy

JOURNAL OPEN ACCESS

2020 Volume 59 Issue 17 Pages 2113-2116

DOI https://doi.org/10.2169/internalmedicine.4684-20

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Abstract

A 68-year-old woman presented with a 2-year history of worsening unsteady gait. Her neurological examination revealed peripheral neuropathy with lower limb sensory dominance. T2-weighted imaging revealed a disorder of the posterior cervical cord. Blood test findings revealed vitamin B₁₂ deficiency, and gastroscopy revealed typical findings of autoimmune gastritis. She received vitamin B₁₂ supplementation, but some peripheral neuropathy symptoms persisted due to longstanding vitamin B₁₂ deficiency. Asymptomatic patients should undergo gastroscopy to detect autoimmune gastritis, as chronic vitamin B₁₂ deficiency causes irreversible peripheral neuropathy.

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