Asunto(s)
Cuerpos Extraños/complicaciones , Fístula Gástrica/etiología , Enfermedades del Yeyuno/etiología , Yeyuno/cirugía , Estómago/cirugía , Adulto , Suministros de Energía Eléctrica , Endoscopía del Sistema Digestivo , Fístula Gástrica/cirugía , Humanos , Fístula Intestinal/etiología , Fístula Intestinal/cirugía , Enfermedades del Yeyuno/cirugía , Litio , Imanes , Masculino , Minerales/uso terapéuticoRESUMEN
A 23-year-old man presented with weakness in the lower limbs, numbness in hands and feet over past 6 months. Examination revealed a combination of absent ankle jerk, extensor plantar response and reduced sensations in a glove and stocking distribution. MRI of the spinal cord was distinctive of subacute combined degeneration (SACD) of the spinal cord. Serum vitamin B12 was low and anti-intrinsic factor antibodies were positive. A biopsy of the stomach revealed intense inflammatory infiltrates in lamina propria with grade III Helicobacter pylori infection. Other work-up for the cause of vitamin B12 deficiency was unremarkable. H pylori infection triggers autoantibodies by a mechanism of molecular mimicry. This case report highlights H pylori as a causative agent in vitamin B12 deficiency and culminating in SACD of the spinal cord. H pylori treatment reverses the underlying pathogenesis and corrects vitamin B12 deficient state in selected individuals.
Asunto(s)
Anemia Perniciosa/etiología , Mucosa Gástrica/microbiología , Infecciones por Helicobacter/complicaciones , Helicobacter pylori/aislamiento & purificación , Degeneración Combinada Subaguda/etiología , Deficiencia de Vitamina B 12/etiología , Anemia Perniciosa/diagnóstico , Biopsia , Diagnóstico Diferencial , Estudios de Seguimiento , Infecciones por Helicobacter/diagnóstico , Infecciones por Helicobacter/microbiología , Humanos , Imagen por Resonancia Magnética , Masculino , Degeneración Combinada Subaguda/diagnóstico , Deficiencia de Vitamina B 12/diagnóstico , Adulto JovenRESUMEN
Pachydermoperiostosis is a rare hereditary disorder that is characterised by pachydermia (thickening of the facial skin and/or scalp), and periostosis (swelling of the periarticular tissue and a subperiosteal new bone formation). Other associated features are arthralgia, polyarthritis, clubbing, seborrhoea, hyperhidrosis, hypertrophic gastropathy, peptic ulcer and gyanecomastia. Eyelid ptosis which is caused by thickened eyelids (blepharoptosis) is a less common association. We are hereby reporting a patient with a complete form of Pachydermoperiostosis, wherein the presenting feature was bilateral ptosis.
