Abstrakt: |
• The diagnosis of pernicious anemia with dorsolateral spinal degeneration was made in two patients, and the progress of the neurological symptoms was halted by treatment with cyanocobalamin. Both patients, however, suffered exacerbations of these symptoms after a lapse of time, which was 13 months in one case and six years in the other. Neither responded to intensified medical treatment. In the first case, an extramedullary, intradural psammomatous meningioma at the 10th thoracic level was found at operation, and removal of the tumor was followed by marked improvement. In the second case, the lesion proved to be an extradural neurofibroma. In both, the initial diagnosis of pernicious anemia was corroborated by a test depending on the absorption of cyanocobalamin labeled with radioactive cobalt. These experiences illustrated the usefulness of the cyanocobalamin-absorption test, the response of patients with pernicious anemia to cyanocobalamin therapy, and the possibility that two unrelated causes of neurological symptoms may coexist in a single patient. |