J Korean Neurol Assoc.  2017 Feb;35(1):22-25. 10.17340/jkna.2017.1.4.

Subacute Combined Degeneration Caused by Chronic Atrophic Gastritis with Spurious Elevation of Vitamin B12 Level

Affiliations
  • 1Department of Neurology, Yeungnam University College of Medicine, Daegu, Korea. minsupark@ynu.ac.kr

Abstract

We report a patient who was diagnosed as subacute combined degeneration (SCD) with elevated homocysteine and methylmalonic acid levels in the situation of a spurious elevation of the vitamin B12 concentration. A false-positive elevation of the vitamin B12 level could lead to a delayed diagnosis and cause irreversible changes in the nervous systems. We therefore suggest that the homocysteine and methylmalonic acid levels should be checked in patients with a normal or elevated vitamin B12 level for whom there is a high clinical suspicion for vitamin B12 deficiency, as a further evaluation for SCD.

Keyword

Subacute combined denegenration; Methylmalonic acid; Homocysteine
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