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biermer disease in an Unusual Neurological Presentation without Anemia: A Case Report

Open Journal of Gastroenterology 2022年第5期12卷 129-135页

作者： Nsenga Djapa Guy Roger Fogang Fogoum Yannick Ndjitoyap Ndam Antonin Wilson Kowo Pierre Mathurin Ankouane Andoulo Firmin Choukem Simon Pierre Department of Internal Medicine and Specialties Faculty of Medicine and Pharmaceutical Sciences University of Dschang Dschang Cameroon Gastroenterology Unit Internal Medicine Service Ebolowa Regional Hospital Ebolowa Cameroon Department of Internal Medicine and Specialties Faculty of Medicine and Biomedical Sciences University of Yaoundé I Ya-oundé Cameroon

Background: biermer disease is a megaloblastic disease caused by vitamin B12 deficiency. It is a rare clinical entity especially in subsahara Africa. Case presentation: We report the case of a 45 years old female patient who consulted for a one month history of generalised muscle cramps, weakness and numbness of all four limbs. Physical examination was relevant for a poor gait, poor coordination of both upper and lower limbs, a positive Romberg sign, normal muscle tone in all four limbs, reduced pallesthesia and deep tendon reflexes, abolished plantar reflexes. Paraclinical investigations revealed macrocytosis without anemia, a low cyanocobalamin (vitamin B12) level with a normal folic acid level, an atrophic corporeofundic mucosa which upon pathological analysis revealed a chronic atrophic gastritis with no Helicobacter pylori infection. Anti-intrinsic factor antibodies were positive while anti parietal cells antibodies were negative. The diagnosis of biermer disease was considered and the patient did well on vitamin B12 supplementation. Conclusion: Though a rare disease, biermer disease should be considered in a patient who consults for polyneuropathy even in the absence of anemia.

关键词： biermer disease Pernicious Anemia Autoimmune disease Atrophic Gastritis Vitamin B12 Deficiency Cameroon

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