Neuro-psychiatrische Symptome bei Vitamin-B12-Mangel und Mikrokarzinoidose: Komplikationen einer chronischen atrophischen Gastritis
| Autor: | K.-M. Müller, L. M. Ossege, J.-P. Malin, T. Pohle, B. May |
|---|---|
| Rok vydání: | 2008 |
| Předmět: |
medicine.medical_specialty
medicine.diagnostic_test biology Atrophic gastritis business.industry Chromogranin A Neurological examination General Medicine medicine.disease Gastroenterology Resorption medicine.anatomical_structure Internal medicine medicine biology.protein Gastric mucosa Vitamin B12 Gastritis medicine.symptom business Mean corpuscular volume |
| Zdroj: | DMW - Deutsche Medizinische Wochenschrift. 121:758-762 |
| ISSN: | 1439-4413 0012-0472 |
| DOI: | 10.1055/s-2007-1024559 |
| Popis: | HISTORY AND FINDINGS A 69-year-old woman reported marked restriction of voluntary movements of the hands in the preceding 6 months. She had also experienced loss of motivation, memory and concentration. Her skin was pale yellow, and scratches on her skin indicated marked pruritus. INVESTIGATIONS Neurological examination revealed decreased vibratory sense in both legs. Haemoglobin concentration was 8.3 g/dl, mean corpuscular volume 114 fl, vitamin B12 level < 100 ng/l, folic acid level normal. Antibody titre against parietal cells was increased, vitamin B12 resorption diminished. Gastroscopy revealed small raised lesions, made up of hyperplastic cells which stained with chromogranin, indicating a diagnosis of microcarcinoid of the gastric mucosa. TREATMENT AND COURSE On administration of cobalamine (1,000 micrograms i.m. daily for 2 weeks, twice weekly for 6 weeks, then once per week for the last 7 months) the blood picture returned to normal, but the microcarcinoids, the psychological symptoms and the apraxia of the hands were unchanged. |
| Databáze: | OpenAIRE |
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