How a common nutritional deficiency turned an air hostess into a beggar
1. A few years ago, a smartly-dressed man entered my OPD with a shabbily-dressed woman, introducing her as his wife. Her hair was unkempt, clothes untidy and she wore a pair of torn sandals.
#MedTwitter
1. A few years ago, a smartly-dressed man entered my OPD with a shabbily-dressed woman, introducing her as his wife. Her hair was unkempt, clothes untidy and she wore a pair of torn sandals.
#MedTwitter
2. The gentleman further added: "She was an airhostess in a German airlines, whom I met while flying as I frequently flew to Germany for business. She was 25-yr old, pretty and it was love at first sight, culminating in #marriage. Things started to change within a few months."
3. She developed progressive #memory impairment, mostly for recent events. She had problems in calculation, speaking, and used to get lost in familiar places. One day, she left home to visit a well-known friend's place, but never reached there. She didn't return home either.
4. After extensive search by police for a week, she was located in a nearby town, found begging for living. Her husband suspected that she had developed a #psychiatric illness. #psychiatrist evaluated her and wanted a #neurologist opinion. That's when he brought her to my clinic.
5. Clinical examination revealed features of severe #Dementia. In addition, she had hyperpigmentation of skin over knuckles and sluggish ankle jerks. MRI brain was normal. Serum Vitamin B12 was 25 pg/mL. Anti-parietal cell and anti-intrinsic factor antibodies were positive.
6. A diagnosis of vitamin B12 deficiency causing dementia & peripheral neuropathy was made. I started her on vitamin B12 injections and asked for periodic review.
Three months later, a young couple walked into OPD on a relatively busy day. I could easily recognize the gentleman.
Three months later, a young couple walked into OPD on a relatively busy day. I could easily recognize the gentleman.
7. But the woman with him appeared "different". Realizing my confusion, he said: "Dr, this is the woman I had married, and not the one you saw in our last visit". "After your treatment, she showed remarkable improvement and her brain functions including memory almost normalized."
Take home message
1. #vitamin #B12 deficiency can cause rapidly progressive, severe dementia in young people.
2. Vitamin B12 deficiency can occur in non-vegetarians too (due to antibodies in gut preventing absorption of B12)
3. Vitamin B12 injections leads to rapid improvement.
1. #vitamin #B12 deficiency can cause rapidly progressive, severe dementia in young people.
2. Vitamin B12 deficiency can occur in non-vegetarians too (due to antibodies in gut preventing absorption of B12)
3. Vitamin B12 injections leads to rapid improvement.
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