NEUROLOGIC ASPECTS OF COBALAMIN DEFICIENCY
NEUROLOGIC ASPECTS OF COBALAMIN DEFICIENCY
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DOI：
10.1097/00005792-199107000-00001
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发表时间：
1991-07-01
期刊：
影响因子：
1.6
通讯作者：
LINDENBAUM, J
中科院分区：
文献类型：
--
作者：
HEALTON, EB;SAVAGE, DG;LINDENBAUM, J
与恶性贫血相关的神经系统疾病在世纪末和本世纪前几十年的文献中有很好的描述（5，17，31，54，67，89，91，94）。许多关于该主题的经典文献都受到某些限制，包括潜在诊断的不确定性和评估不同效力的肝脏制剂治疗的问题。没有大量详细的维生素B患者系列，自从引入各种现代诊断和治疗措施，包括Schilling试验、血清Cbl水平和用纯化维生素B治疗以来，已经发表了影响神经系统的（钴胺素，Cbl）缺乏症，尽管已经出现了许多涉及单个患者或少数患者的报告（7，17，28，38，43，47，49，65，71，87，91，98）。人们注意到，现代Cbl缺乏症患者的临床表现与过去不同，并且不如过去先进（22）。近年来由于缺乏Cbl而导致的神经系统疾病可能对治疗更有反应，并且显示出比以前观察到的更高程度的可逆性（8，17，27，31，43，44，67，75，88，89，96）。在这里，我们提出了一个审查的介绍和治疗反应的一个大系列的患者有充分的记录Cbl缺乏谁在2所大学医院在最近的17年期间进行了研究。
The neurologic disorders associated with perni-cious anemia were well described in the literature of the late nineteenth century and the first decades of this century (5, 17, 31, 54, 67, 89, 91, 94). Much of the classic literature on the topic is subject to certain limitations, including uncertainty as to underlying diagnosis and problems in evaluating therapy with liver preparations of varying potency. No large detailed series of patients with vitamin B,(cobalamin, Cbl) deficiency affecting the nervous system has been published since the introduction of various modern diagnostic and therapeutic measures, including the Schilling test, serum Cbl level and treatment with purified vitamin B, although many reports involving single patients or small numbers of patients have appeared (7, 17, 28, 38, 43, 47, 49, 65, 71, 87, 91, 98). It has been noted that clinical presentation of patients with Cbl deficiency during the modern era has been different and less advanced than in the past (22). It is possible that neurologic disorders due to lack of Cbl seen in recent years may be more responsive to therapy and show a higher degree of reversibility than has been observed previously (8, 17, 27, 31, 43, 44, 67, 75, 88, 89, 96). We present here a review of the presentations and responses to treatment of a large series of patients with well-documented Cbl deficiency who were studied at 2 university hospitals during a recent 17-year period.