Degeneración subaguda combinada secundaria a infección crónica por Helicobacter pylori. Reporte de caso
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jul 31, 2014
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Resumen
La degeneración subaguda combinada es una patología poco frecuente. El diagnóstico se establece correlacionando el cuadro clínico, los resultados de laboratorio y los hallazgos en la resonancia magnética. Se presenta el caso de una mujer con síntomas neurológicos característicos de mielopatía con nivel sensitivo C5, con imágenes de resonancia magnética cervical que revelan una afectación desmielinizante exclusivamente en los cordones posteriores de la médula espinal. Clínicamente se documentó anemia, gastritis crónica e infección por Helicobacter pylori, además de déficit paraclínico de cianocobalamina.
Keywords
degeneración subaguda combinada, anemia perniciosa, mielopatía, Subacute combined degeneration, pernicious anemia, myelopathy,
References
1. Healton EB, Savage DG, Brust JC, Garrett TJ, Lindenbaum J. Neurologic aspects of cobalamin deficiency. Medicine. 1991;70:229-45.
2. Hughes JT. Pathology of the spinal cord. 2nd ed. In: Bennington J, editor. Major problems in pathology. Vol. 6. Philadelphia, Pa: Saunders; 1978. p. 192-6.
3. Lindenbaum J, Healton EB, Savage DG. Neuropsychiatric disorders caused by cobalamin deficiency in the absence of anemia or macrocytosis. N Engl J Med. 1998;318:1720-8.
4. Andrès E, Loukili NH, Noel E, et al. Vitamin B12 (cobalamin) deficiency in elderly patients. CMAJ. 2004;171(3):251-9.
5. Lindenbaum J, Rosenberg IH, Wilson PWF, Stabler SP, Allen RH. Prevalence of cobalamin deficiency in the Framingham elderly population. Am J Clin Nutr. 1994;60:2-11.
6. Kaptan K, Beyan C, Ural AU, Cetin T, Avcu F, Gulsen M, et al. Helicobacterpylori-is it a novel causative agent in Vitamin B12 deficiency? Arch Intern Med. 2000;160:1349-53.
7. Green R, Kinsella LJ. Current concepts in the diagnosis of cobalamin deficiency. Neurology. 1995;45:1435-40.
8. Clementz GL, Schade SG. The spectrum of vitamin B12 deficiency. Am Fam Physician. 1990;41:150-62.
9. Beck WS. Neuropsychiatric consequence of cobalamin deficiency. In: Stollerman GH, editor. Advances in internal medicine. Vol. 36. St Louis, Mo: Mosby-Year Book; 1991. p. 33-56.
10. De Rosa A, Rossi F, Lieto M, Bruno R, De Renzo A, Palma V, Quarantelli M, De Michele G. Subacute combined degeneration of the spinal cord in a vegan. Clin Neurol Neurosurg. 2012 Sep;114(7):1000-2.
11. Naidich MJ, Ho SU. Case 87: Subacute combined degeneration. Radiology. 2005 Oct;237(1):101-5.
12. Thomas PK. Subacute combined degeneration. J Neurol Neurosurg Psychiatry. 1998 Dec;65(6):807.
13. Hemmer B, Glocker FX, Schumacher M, Deuschl G, Lücking CH. Subacute combined degeneration: clinical, electrophysiological, and magnetic resonance imaging findings. J Neurol Neurosurg Psychiatry. 1998 Dec;65(6):822-7.
14. Katsaros VK, Glocker FX, Hemmer B, Schumacher M. MRI of spinal cord and brain lesions in subacute combined degeneration. Neuroradiology. 1998 Nov;40(11):716-9.
15. Ravina B, Loevner LA, Bank W. MR findings in subacute combined degeneration of the spinal cord: a case of reversible cervical myelopathy. AJR Am J Roentgenol. 2000 Mar;174(3):863-5.
16. Sun H, Lee J, Park K, Wi J, Kang H. Spine MR imaging features of subacute combined degeneration patients. European Spine Journal [internet]. 2014 [citado 2014 Jul 17];23(5):1052-8.
2. Hughes JT. Pathology of the spinal cord. 2nd ed. In: Bennington J, editor. Major problems in pathology. Vol. 6. Philadelphia, Pa: Saunders; 1978. p. 192-6.
3. Lindenbaum J, Healton EB, Savage DG. Neuropsychiatric disorders caused by cobalamin deficiency in the absence of anemia or macrocytosis. N Engl J Med. 1998;318:1720-8.
4. Andrès E, Loukili NH, Noel E, et al. Vitamin B12 (cobalamin) deficiency in elderly patients. CMAJ. 2004;171(3):251-9.
5. Lindenbaum J, Rosenberg IH, Wilson PWF, Stabler SP, Allen RH. Prevalence of cobalamin deficiency in the Framingham elderly population. Am J Clin Nutr. 1994;60:2-11.
6. Kaptan K, Beyan C, Ural AU, Cetin T, Avcu F, Gulsen M, et al. Helicobacterpylori-is it a novel causative agent in Vitamin B12 deficiency? Arch Intern Med. 2000;160:1349-53.
7. Green R, Kinsella LJ. Current concepts in the diagnosis of cobalamin deficiency. Neurology. 1995;45:1435-40.
8. Clementz GL, Schade SG. The spectrum of vitamin B12 deficiency. Am Fam Physician. 1990;41:150-62.
9. Beck WS. Neuropsychiatric consequence of cobalamin deficiency. In: Stollerman GH, editor. Advances in internal medicine. Vol. 36. St Louis, Mo: Mosby-Year Book; 1991. p. 33-56.
10. De Rosa A, Rossi F, Lieto M, Bruno R, De Renzo A, Palma V, Quarantelli M, De Michele G. Subacute combined degeneration of the spinal cord in a vegan. Clin Neurol Neurosurg. 2012 Sep;114(7):1000-2.
11. Naidich MJ, Ho SU. Case 87: Subacute combined degeneration. Radiology. 2005 Oct;237(1):101-5.
12. Thomas PK. Subacute combined degeneration. J Neurol Neurosurg Psychiatry. 1998 Dec;65(6):807.
13. Hemmer B, Glocker FX, Schumacher M, Deuschl G, Lücking CH. Subacute combined degeneration: clinical, electrophysiological, and magnetic resonance imaging findings. J Neurol Neurosurg Psychiatry. 1998 Dec;65(6):822-7.
14. Katsaros VK, Glocker FX, Hemmer B, Schumacher M. MRI of spinal cord and brain lesions in subacute combined degeneration. Neuroradiology. 1998 Nov;40(11):716-9.
15. Ravina B, Loevner LA, Bank W. MR findings in subacute combined degeneration of the spinal cord: a case of reversible cervical myelopathy. AJR Am J Roentgenol. 2000 Mar;174(3):863-5.
16. Sun H, Lee J, Park K, Wi J, Kang H. Spine MR imaging features of subacute combined degeneration patients. European Spine Journal [internet]. 2014 [citado 2014 Jul 17];23(5):1052-8.
Cómo citar
Márquez, J. C., de Valencia, C., Ramírez, S. M., & Uribe Vargas, M. (2014). Degeneración subaguda combinada secundaria a infección crónica por Helicobacter pylori. Reporte de caso. Universitas Medica, 55(4), 466–471. https://doi.org/10.11144/Javeriana.umed55-4.dscs
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Reportes de caso