Central Nervous System Complication due to Pernicious Anemia in a Patient with Rheumatoid Arthritis.
10.4078/jrd.2015.22.5.327
- Author:
Jae Myung LEE
1
;
Jee Won CHAI
;
Kichul SHIN
Author Information
1. Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea. kideb1@gmail.com
- Publication Type:Case Report
- Keywords:
Pernicious anemia;
Rheumatoid arthritis;
Vitamin B12
- MeSH:
Absorption;
Anemia;
Anemia, Pernicious*;
Arthritis, Rheumatoid*;
Autoimmune Diseases;
Central Nervous System*;
Extremities;
Female;
Gastritis, Atrophic;
Humans;
Hypesthesia;
Ileum;
Intrinsic Factor;
Korea;
Magnetic Resonance Imaging;
Middle Aged;
Myelodysplastic Syndromes;
Proprioception;
Subacute Combined Degeneration;
Vibration;
Vitamin B 12
- From:Journal of Rheumatic Diseases
2015;22(5):327-331
- CountryRepublic of Korea
- Language:English
-
Abstract:
Pernicious anemia (PA) is an autoimmune disease characterized by atrophic gastritis and deficiency in intrinsic factor leading to impairment of vitamin B12 absorption in the ileum. Anemia is commonly found in rheumatoid arthritis (RA); however, PA is rarely found in RA. There are few reports describing patients with both conditions; none in Korea to date. We report on a case of a 46-year-old female who presented with hypesthesia and general weakness. She was previously diagnosed as seropositive RA with myelodysplastic syndrome. She had severely impaired sensation, especially for vibration and proprioception in all limbs. Subacute combined degeneration was observed on her magnetic resonance imaging and serum vitamin B12 level was very low. Further exam results were consistent with PA and her symptoms improved with cobalamin injection. This case demonstrates that PA should be considered in RA patients presenting with both central nervous system manifestations and anemia.
