Mental symptoms in vitamin-B-12 deficiency.
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A COMMON CONDITION: Vitamin B12 deficiency is common in the elderly. Search for deficiency should be undertaken whenever the clinical situation could lead to vitamin deficiency whether macrocytic anemia is present or not as its development may come late. PATHOPHYSIOLOGICAL IMPLICATIONS: The potential relationships between degenerative neuropsychiatric disorders and cerebrovascular or cardiovascular disease, mainly via hyperhomocysteinemia, emphasize the importance of searching for vitamin B12 deficiency in the elderly. SPECIFIC CAUSES: In the elderly, it is important to recognize specific causes of vitamin B12 deficiency, mainly resulting from vitamin malabsorption.
We present a case of extreme pancytopenia in a 27-year-old pregnant woman. The initial picture was compatible with a severe hematological problem in the category of aplastic anemia, paroxysmal nocturnal hemoglobinuria or even acute leukemia. The further biochemical investigations revealed, however, a folate deficiency. Nowadays this is a very rare cause of pancytopenia. Next to this she also had a Vitamin B(12) deficiency due to intrinsic factor failure. The recent literature is discussed.
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As a clue to clarifying the role of vitamin B12 (B12) in the function of the complement system, serum C3 content was determined in B12-deficient rats, and the effect of the administration of methylcobalamin (CH3-B12) on the serum C3 content was also studied. It was found that the serum C3 content in rats fed on a vitamin B12-deficient diet for 90 and 120 days significantly decreased compared with that in control rats. The administration of CH3-B12) restored the serum C3 content to control levels. The above results indicate that B12-deficiency depressed the serum C3 content and lowered humoral immunocompetence, and that these changes were ascribable to B12-deficiency.
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