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Reversible Dementia and Neuropathy Associated with Folate Deficiency 16 Years After Partial Gastrectomy
Author(s) -
Enk C.,
Hougaard K.,
Hippe E.
Publication year - 1981
Publication title -
scandinavian journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 84
eISSN - 1600-0609
pISSN - 0036-553X
DOI - 10.1111/j.1600-0609.1981.tb01366.x
Subject(s) - gastrectomy , dementia , medicine , pediatrics , surgery , cancer , disease
A 57‐year‐old woman developed dementia and peripheral neuropathy 16 years after a partial gastrectomy (Billroth II). Serum cobalamin was 198 pmol/l (reference interval 150–550), and the vitamin B 12 absorption test (Schilling) showed decreased absorption (1.7% without and 2.2% with intrinsic factor). In spite of 20 months' therapy with vitamin B 12 , the neurological symptoms progressed. Folate deficiency was suggested by a very low erythrocyte folate and a slightly abnormal FIGLU test. There were no other signs of general malabsorption. A few months' treatment with folic acid significantly improved the massive neurological manifestations which were verified neurophysiologically as well as histologically. A common role of vitamin B 12 and folate in the development of neuropathy is suggested.