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CASE REPORT |
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Volume 26 |
July - September 2010 |
Number 3 |
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Published by : PROFESSIONAL MEDICAL PUBLICATIONS |
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ISSN 1681-715X |
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CASE REPORT |
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Volume 26 |
July - September 2010 |
Number 3 |
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Megaloblastic Anemia Patient admitted with
Pancytopenia and Walking Difficulty with
normal Vitamin B12 and MCV LevelsOsman Yokus 1, Ozlem Sahin Balcik 2, Murat Albayrak 3
ABSTRACT
Vitamin B12 deficiency may cause hematologic, gastrointestinal, psychiatric and neurological symptoms. Sub-acute combined degeneration of spinal cord, which develops in the deficiency of vitamin B12, may be reversible in case of early diagnosis and treatment. We describe the management of a 50-years old female who got admitted with pancytopenia and elevated LDH, with walking difficulties since last 15 days. B12 and folic acid levels were found in normal ranges. Megaloblastic changes were observed in the bone marrow examination. Abnormal hyperintence signal changes were observed in T2-weighed cervical spinal cord Magnetic Resonance Imaging in posterior row. Due to the high homocysteine level, treatment with parenteral B12 vitamin was initiated. Following the 3-months treatment, hematologic counts and neurological symptoms of the patient were found to be completely recovered at the control visit. Vitamin B12 deficiency should be considered for the patients with pancytopenia, elevated LDH levels and neurological symptoms, even if vitamin B12 and MCV levels are in normal ranges. Vitamin B12 deficiency should be confirmed with the additional assays, such as, the assessment of serum homocysteine and methylmalonic acid levels, and the treatment should be started promptly.
KEY WORDS:
Vitamin B12, Pancytopenia, Subacute Combined Degeneration.Pak J Med Sci July - September 2010 Vol. 26 No. 3 736-739
How to cite this article:
Yokus O, Balcik OS, Albayrak M. Megaloblastic Anemia Patient admitted with Pancytopenia and Walking Difficulty with normal Vitamin B12 and MCV Levels. Pak J Med Sci 2010;26(3):736-739
1. Osman Yokus, MD,
Dept. of Hematology, Sema Hospital,
Istanbul, Turkey
2. Ozlem Sahin Balcik, MD,
Dept. of Hematology,
Fatih University Medical School, Ankara, Turkey.
3. Murat Albayrak, MD,
Dept. of Hematology,
Diskapi Yildirim Beyazit Education & Research Hospital,
Ankara, Turkey.
Correspondence:
Dr. Ozlem Sahin Balcik,
Dizgi Sokak 9/6 Basinevleri 06120 Ankara, TURKEY.
E-mail: drozlembalcik@yahoo.com
* Received for Publication: February 19, 2010
* Accepted: May 20, 2010
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