Database : MEDLINE
Search on : Subacute and Combined and Degeneration [Words]
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[PMID]: 29190137
[Au] Autor:Hughes JW; Muegge BD; Tobin GS; Litvin M; Sun L; Saenz JB; Gyawali CP; McGill JB
[Ti] Title:HIGH-RISK GASTRIC PATHOLOGY AND PREVALENT AUTOIMMUNE DISEASES IN PATIENTS WITH PERNICIOUS ANEMIA.
[So] Source:Endocr Pract;23(11):1297-1303, 2017 Nov.
[Is] ISSN:1530-891X
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:OBJECTIVE: Pernicious anemia (PA) develops from atrophic gastritis due to autoimmune destruction of parietal cells and results in achlorhydria, vitamin B12 and iron deficiencies, anemia, neurologic deficits, and premalignant and malignant stomach lesions. We report the presentation, diagnosis and gastric complications of PA in patients from an endocrinology practice. METHODS: Thirty-four patients (31 female, 3 male) with PA who underwent esophagogastroduodenoscopy (EGD) or gastrectomy were identified. Pertinent clinical, laboratory, and pathology findings were reviewed and summarized. RESULTS: The mean age of patients was 58.6 ± 14.2 years; the onset of PA was age 50.2 ± 15.3 years. Anemia reflected vitamin B12 and/or iron deficiencies. Parietal cell antibodies (PCA) were detected in 97% of patients, and intrinsic factor blocking antibody (IFBA) was found in 52%. Fasting gastrin and chromogranin A levels were elevated (1,518.0 ± 1,588.3 pg/mL, and 504.9.1 ± 1,524.9 ng/mL respectively). Autoimmune or immunologic diseases (AIDs) were present in 32/34 patients. Stomach pathology showed premalignant or malignant lesions in 26 patients, including gastric neuroendocrine tumors (GNETs) in 6 and adenocarcinoma in 1. One patient presented with neurologic symptoms and subacute combined degeneration of the posterior column of the spinal cord. CONCLUSION: PA should be suspected in patients with unexplained anemia or neurologic symptoms. The diagnosis of PA relies on fasting gastrin and gastric auto-antibody testing, in addition to hematologic evaluation. EGD with measurement of gastric pH and biopsies of the fundus and antrum identifies patients with achlorhydria, atrophic gastritis, and premalignant and malignant stomach lesions. EGD surveillance of patients with high-risk stomach lesions is recommended. ABBREVIATIONS: AID = autoimmune or immunologic disease; EGD = esophagogastroduodenoscopy; GNET = gastric neuroendocrine tumor; IFBA = intrinsic factor blocking antibody; PA = pernicious anemia; PCA = parietal cell antibody; T1D = type 1 diabetes.
[Mh] MeSH terms primary: Anemia, Pernicious/etiology
Autoimmune Diseases/complications
Gastric Mucosa/pathology
[Mh] MeSH terms secundary: Adolescent
Adult
Aged
Aged, 80 and over
Endoscopy, Digestive System
Female
Gastrectomy
Gastrins/blood
Gastritis, Atrophic/complications
Humans
Male
Middle Aged
Retrospective Studies
Young Adult
[Pt] Publication type:JOURNAL ARTICLE
[Nm] Name of substance:0 (Gastrins)
[Em] Entry month:1803
[Cu] Class update date: 180301
[Lr] Last revision date:180301
[Js] Journal subset:IM
[Da] Date of entry for processing:171201
[St] Status:MEDLINE
[do] DOI:10.4158/EP-2017-0056

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[PMID]: 29282001
[Au] Autor:Yuan JL; Wang SK; Jiang T; Hu WL
[Ad] Address:Department of Neurology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, 100020, China.
[Ti] Title:Nitrous oxide induced subacute combined degeneration with longitudinally extensive myelopathy with inverted V-sign on spinal MRI: a case report and literature review.
[So] Source:BMC Neurol;17(1):222, 2017 Dec 28.
[Is] ISSN:1471-2377
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:BACKGROUND: Nitrous oxide (N2O), a long-standing anesthetic, is also neurotoxic by interfering with the bioavailability of vitamin B12 if abused. A few case studies have reported the neurological and psychiatric complications of N2O. CASE PRESENTATION: Here, we reported a patient of N2O induced subacute combined degeneration (SCD) with longitudinally extensive myelopathy with inverted V-sign exhibiting progressive limb paresthesia and unsteady gait. CONCLUSIONS: This case raises the awareness of an important mechanism of neural toxicity of N2O, and clinical physicians should be well recognized this in the field of substance-related disorders.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1712
[Cu] Class update date: 180104
[Lr] Last revision date:180104
[St] Status:In-Process
[do] DOI:10.1186/s12883-017-0990-3

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[PMID]: 29269366
[Au] Autor:Schimana R; Ober H; Neuhaus O
[Ad] Address:Department of Neurology, SRH Kliniken Landkreis Sigmaringen GmbH, Sigmaringen, Germany.
[Ti] Title:Subacute combined degeneration of the spinal cord in vitamin B and copper deficiency.
[So] Source:BMJ Case Rep;2017, 2017 Dec 20.
[Is] ISSN:1757-790X
[Cp] Country of publication:England
[La] Language:eng
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1712
[Cu] Class update date: 171222
[Lr] Last revision date:171222
[St] Status:In-Data-Review

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[PMID]: 29054315
[Au] Autor:Spain JA; Cressman S; Marin H; Patel SC; Corrigan JJ; Griffith B
[Ad] Address:Department of Radiology, Henry Ford Health System, Detroit, MI. Electronic address: jamess@rad.hfh.edu.
[Ti] Title:Cord Topographical Anatomy and its Role in Evaluating Intramedullary Lesions.
[So] Source:Curr Probl Diagn Radiol;, 2017 Sep 18.
[Is] ISSN:1535-6302
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Intramedullary spinal lesions present a wide differential diagnosis including infectious, inflammatory, traumatic, ischemic, benign, or malignant neoplastic etiologies. Using knowledge of anatomy and physiology within the spinal cord, many similar appearing entities can be parsed into a prioritized differential. The purpose of this article is to review anatomy and pathophysiology of the spinal cord, with subsequent discussion of how this knowledge can be used to differentiate several similar appearing intramedullary pathologic processes. Discussion includes the pathophysiology, imaging findings, and clinical pearls of several intramural lesions including infarct, demyelinating lesions, traumatic injury, neoplasm, vascular malformation, and metabolic processes such as subacute combined degeneration.
[Pt] Publication type:JOURNAL ARTICLE; REVIEW
[Em] Entry month:1710
[Cu] Class update date: 171021
[Lr] Last revision date:171021
[St] Status:Publisher

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[PMID]: 29046759
[Au] Autor:Wazir SM; Ghobrial I
[Ad] Address:Department of Internal Medicine, UPMC Mercy Hospital, Pittsburgh, PA, USA.
[Ti] Title:Copper deficiency, a new triad: anemia, leucopenia, and myeloneuropathy.
[So] Source:J Community Hosp Intern Med Perspect;7(4):265-268, 2017 Oct.
[Is] ISSN:2000-9666
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Clinical copper deficiency is now more frequently recognized. Hematologically, it can present as anemia (microcytic, normocytic, or macrocytic) and neutropenia. Thrombocytopenia is relatively rare. Neurologically, it can manifest as myelopathy and peripheral neuropathy simulating subacute combined degeneration. Bone marrow findings can mimic myelodysplasia resulting in occasional inappropriate referral for bone marrow transplantation. Other conditions with similar presentations include infections, drug toxicity, autoimmunity, B deficiency, folate deficiency, myelodysplastic syndrome, aplastic anemia, and lymphoma with bone marrow involvement. Hematological, but not neurological, manifestations respond promptly to copper replacement, making early diagnosis essential for good outcome. Common risk factors for copper deficiency are foregut surgery, dietary deficiency, enteropathies with malabsorption, and prolonged intravenous nutrition (total parenteral nutrition). We present a unique case of copper deficiency, with no apparent known risk factors.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1710
[Cu] Class update date: 171022
[Lr] Last revision date:171022
[St] Status:PubMed-not-MEDLINE
[do] DOI:10.1080/20009666.2017.1351289

  6 / 434 MEDLINE  
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[PMID]: 29036641
[Au] Autor:Matsuura H; Nakamura T
[Ad] Address:Mitoyo General Hospital, 708, Himehama, Toyohama-cho, Kanonji-city, Kagawa, 769-1695 Japan.
[Ti] Title:Inverted V sign; subacute combined degeneration of the spinal cord.
[So] Source:QJM;, 2017 Oct 03.
[Is] ISSN:1460-2393
[Cp] Country of publication:England
[La] Language:eng
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1710
[Cu] Class update date: 171016
[Lr] Last revision date:171016
[St] Status:Publisher
[do] DOI:10.1093/qjmed/hcx189

  7 / 434 MEDLINE  
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[PMID]: 28797832
[Au] Autor:Goldish D; Massagli TL
[Ad] Address:Department of Rehabilitation Medicine, University of Washington, Box 356490, Seattle, WA 98195. Electronic address: dangolduw@gmail.com.
[Ti] Title:Subacute Progressive Myelopathy: Transverse Myelitis or Subacute Combined Degeneration? A Case Report.
[So] Source:PM R;, 2017 Aug 07.
[Is] ISSN:1934-1563
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Evolving subacute myelopathies have many possible etiologies. This is a report of a patient who presented with progressive paresthesias, proprioceptive loss, and gait disturbance with acute myelitis seen on magnetic resonance imaging initially concerning for transverse myelitis. However, she also had vitamin B12 deficiency, and her clinical course ultimately suggested a diagnosis more compatible with subacute combined degeneration. The clinical features, laboratory, and imaging findings and prognosis of the 2 disorders are compared.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1708
[Cu] Class update date: 171016
[Lr] Last revision date:171016
[St] Status:Publisher

  8 / 434 MEDLINE  
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[PMID]: 28667382
[Au] Autor:Weidauer S; Wagner M; Nichtweiß M
[Ad] Address:Department of Neurology, Sankt Katharinen Hospital, Teaching Hospital of the Goethe University, Frankfurt, Seckbacher Landstraße 65, 60389, Frankfurt/Main, Germany. stefan.weidauer@sankt-katharinen-ffm.de.
[Ti] Title:Magnetic Resonance Imaging and Clinical Features in Acute and Subacute Myelopathies.
[So] Source:Clin Neuroradiol;, 2017 Jun 30.
[Is] ISSN:1869-1447
[Cp] Country of publication:Germany
[La] Language:eng
[Ab] Abstract:Differential diagnosis of acute and subacute transverse myelopathy includes inflammatory, infectious, vascular, metabolic and paraneoplastic etiologies. Information on the diagnostic approach to transverse myelopathy with regard to daily clinical practice is provided. The differentiation between five lesion patterns on magnetic resonance imaging (MRI) in myelitis may be helpful: (1) longitudinal extensive transverse myelitis, (2) short segment ovoid or peripherally located, (3) "polio-like", (4) granulomatous and (5) segmental with rash. A correlation with these imaging features is supported if the clinical course and neurological symptoms are known. Although the mean interval from onset to nadir of symptoms in spinal cord infarction is 1 h, an overlap with a fulminant course of myelitis is possible, and impaired diffusion may also occur in acute inflammatory processes. As a result, laboratory testing, including aquaporin-4 antibodies and cerebrospinal fluid analysis, is crucial for the correct interpretation of imaging findings. Moreover, the discrimination of acute complete and acute partial transverse myelitis is advantageous in order to identify diverse entities, the latter often being a precursor to multiple sclerosis. Additional brain imaging is mandatory in suspected demyelinating, infectious, neoplastic and systemic autoimmune disease. A symmetrical lesion pattern restricted to individual tracts or dorsal columns indicates subacute combined degeneration of the spinal cord and, in addition to deficiency syndromes, a paraneoplastic etiology should be considered.
[Pt] Publication type:JOURNAL ARTICLE; REVIEW
[Em] Entry month:1707
[Cu] Class update date: 170701
[Lr] Last revision date:170701
[St] Status:Publisher
[do] DOI:10.1007/s00062-017-0604-x

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[PMID]: 28659010
[Au] Autor:King D; Siau K; Senthil L; Kane KF; Cooper SC
[Ad] Address:1 University Hospitals Birmingham, Birmingham, United Kingdom.
[Ti] Title:Copper Deficiency Myelopathy After Upper Gastrointestinal Surgery.
[So] Source:Nutr Clin Pract;:884533617713955, 2017 Jun 01.
[Is] ISSN:1941-2452
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:A well-functioning alimentary canal is required for adequate nutrient absorption. Disruption to the upper gastrointestinal tract through surgery can lead to micronutrient malnourishment. Copper deficiency has been noted in up to 10% of those undergoing Roux-en-Y gastric bypass surgery, but sequalae are not frequently reported. The resultant deficiency states can have profound and long-term consequences if not realized early and managed appropriately. Here we present a case of copper deficiency myelopathy, a condition indistinguishable from subacute combined degeneration of the spinal cord, following upper gastrointestinal bypass surgery for gastric ulceration, further complicated by inadequate nutrition.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1706
[Cu] Class update date: 170629
[Lr] Last revision date:170629
[St] Status:Publisher
[do] DOI:10.1177/0884533617713955

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[PMID]: 28294987
[Au] Autor:Franques J; Chiche L; Mathis S
[Ad] Address:Hôpital de La Casamance, 13400 Aubagne, France. j.franques@hp-lacasamance.fr.
[Ti] Title:Sensory Neuronopathy Revealing Severe Vitamin B12 Deficiency in a Patient with Anorexia Nervosa: An Often-Forgotten Reversible Cause.
[So] Source:Nutrients;9(3), 2017 Mar 15.
[Is] ISSN:2072-6643
[Cp] Country of publication:Switzerland
[La] Language:eng
[Ab] Abstract:Vitamin B12 (B12) deficiency is known to be associated with various neurological manifestations. Although central manifestations such as dementia or subacute combined degeneration are the most classic, neurological manifestations also include sensory neuropathies. However, B12 deficiency is still rarely integrated as a potential cause of sensory neuronopathy. Moreover, as many medical conditions can falsely normalize serum B12 levels even in the context of a real B12 deficiency, some cases may easily remain underdiagnosed. We report the illustrating case of an anorexic patient with sensory neuronopathy and consistently normal serum B12 levels. After all classical causes of sensory neuronopathy were ruled out, her clinical and electrophysiological conditions first worsened after folate administration, but finally improved dramatically after B12 administration. B12 deficiency should be systematically part of the etiologic workup of sensory neuronopathy, especially in a high risk context such as anorexia nervosa.
[Mh] MeSH terms primary: Anorexia Nervosa/blood
Motor Neuron Disease/blood
Vitamin B 12 Deficiency/blood
Vitamin B 12 Deficiency/diagnosis
Vitamin B 12/blood
[Mh] MeSH terms secundary: Adult
Female
Folic Acid/administration & dosage
Folic Acid/blood
Humans
Motor Neuron Disease/diagnosis
Vitamin B 12/administration & dosage
Vitamin E/blood
[Pt] Publication type:CASE REPORTS
[Nm] Name of substance:1406-18-4 (Vitamin E); 935E97BOY8 (Folic Acid); P6YC3EG204 (Vitamin B 12)
[Em] Entry month:1709
[Cu] Class update date: 170912
[Lr] Last revision date:170912
[Js] Journal subset:IM
[Da] Date of entry for processing:170316
[St] Status:MEDLINE


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