vitamin-b-12 and Hypesthesia

We studied the effect of prostaglandin E1.alpha CD (PGE1) on diabetic peripheral neuropathy by evaluating subjective symptoms and vibration sensation using a new vibrometer (SMV-5). Patients with diabetic neuropathy (n = 38) were divided into three groups; group A received no drugs (control), group B was treated with 1500 micrograms/day of oral methyl vitamin B12 (VB12) for four weeks, and group C received 1.2 micrograms/kg/day PGE1 intravenously for four weeks. There was a close relationship between symptom scores and vibratory threshold (VT). The effect of PGE1 on subjective symptoms and VT were compared with those in groups A and B. Patients who received PGE1 showed a significant improvement rate in pain and hypesthesia compared to patients in groups A and B, and in numbness compared to group A. During the study period, there was no significant change in VT in groups A and B, whereas VT was significantly improved at styloid process (P < 0.05) and at medial malleolus (P < 0.001) in group C. Our results confirmed that PGE1 significantly improved both subjective symptoms and VT, indicating that PGE1 therapy may be useful in diabetic neuropathy.

Topics: Administration, Oral; Adult; Aged; Alprostadil; Diabetes Mellitus, Type 2; Diabetic Neuropathies; Dose-Response Relationship, Drug; Female; Humans; Hypesthesia; Injections, Intravenous; Male; Middle Aged; Pain Threshold; Vitamin B 12

A 62-year-old Japanese woman developed numbness of the extremities and megaloblastic anemia. She had undergone total abdominal hysterectomy, whole-pelvis radiation therapy and chemotherapy for gynecological cancer 10 years before. Chronic abdominal pain, diarrhea and intermittent small-bowel obstruction had afflicted her for a long time. We diagnosed her with vitamin B12 deficiency anemia and polyneuropathy due to chronic radiation enteritis causing malabsorption. Vitamin B12 injections improved her numbness and anemia. The early diagnosis and treatment of deficiency of vitamin B12 are important. Physicians should regularly measure vitamin B12 levels and supplement vitamin B12 as needed in patients with chronic radiation enteritis.

Topics: Anemia, Megaloblastic; Enteritis; Female; Gastrointestinal Diseases; Genital Neoplasms, Female; Humans; Hypesthesia; Malabsorption Syndromes; Middle Aged; Polyneuropathies; Radiation Injuries; Vitamin B 12; Vitamin B 12 Deficiency

Little research has been conducted into hypoesthesia, and no studies have elucidated the risk factors for refractory hypoesthesia and compared treatment modalities. The purpose of this multicentre retrospective cohort study was to investigate the relationships between various risk factors, treatment modalities, and refractory hypoesthesia. Risk factors for refractory hypoesthesia after oral surgery were evaluated using univariate and multivariate analysis. To minimize the selection bias associated with a retrospective data analysis, a propensity score analysis was performed between the medication and non-medication groups (65 sites in each group). Moderate or severe hypoesthesia (odds ratio 13.42) and no or late administration of ATP/vitamin B12 (odds ratio 2.28) were significantly associated with refractory hypoesthesia. In the propensity score analysis, the incidence rate of refractory hypoesthesia in the medication group was lower than that in the non-medication group (P<0.001). This study demonstrated the multivariate relationships between various risk factors, treatment modalities, and refractory hypoesthesia. Moderate or severe hypoesthesia and no or late administration of ATP/vitamin B12 were significantly associated with refractory hypoesthesia. Therefore, clinicians should consider these risk factors and initiate early oral administration of ATP/vitamin B12 in cases of hypoesthesia.

Topics: Adenosine Triphosphate; Adolescent; Adult; Aged; Aged, 80 and over; Female; Humans; Hypesthesia; Male; Mandibular Nerve; Middle Aged; Oral Surgical Procedures; Postoperative Complications; Propensity Score; Retrospective Studies; Risk Factors; Treatment Outcome; Trigeminal Nerve Injuries; Vitamin B 12

The study aimed to analyze the clinical characteristics, laboratory test results, neuroimaging findings, and outcomes in patients diagnosed with subacute combined degeneration (SCD).. A total of 68 patients with SCD who had been appropriately treated for no less than 6 months were included in our study. Histories, results of routine blood tests, biochemical indices, serum vitamin B12 levels, and spinal magnetic resonance imaging (MRI) findings from the patients were studied and analyzed. Clinical signs and symptoms, graded using a functional disability rating scale, were scored at the time of admission and 3 and 6 months after admission.. Limb numbness, limb weakness, and gait disturbances were the most common symptoms in patients with SCD. All patients showed clinical improvement to different degrees at the follow-up visits after vitamin B12 treatment. No differences in rating score were found in patients grouped by sex, hemoglobin level, serum vitamin B12, or MRI manifestations at the time of admission or at the follow-up visits. Younger patients and those with shorter disease courses had better rating scores at the short-term follow-up visits.. Anemia, low levels of serum vitamin B12, and MRI abnormalities in the spinal cord are not expected to be associated with worse clinical manifestations. The age of onset and course of disease are important in evaluating the short-term prognosis of patients with SCD.

Topics: Adult; Disease Progression; Female; Follow-Up Studies; Gait Disorders, Neurologic; Humans; Hypesthesia; Magnetic Resonance Imaging; Male; Middle Aged; Neuroimaging; Retrospective Studies; Subacute Combined Degeneration; Vitamin B 12; Vitamin B 12 Deficiency

Patients with thalassemia trait (TT) may have anemia. This study evaluated whether TT patients had specific oral manifestations and a particular blood profile compared with normal individuals.. The oral manifestations and mean red blood cell count, corpuscular cell volume, red blood cell distribution width, Mentzer index, and Green and King index as well as blood concentrations of hemoglobin, iron, total iron binding capacity, vitamin B12, folic acid, and homocysteine in 65 TT patients and in 130 age- and sex-matched healthy controls were measured and compared.. TT patients had significantly higher frequencies of all oral manifestations than healthy controls (p < 0.001 for all), in which burning sensation of oral mucosa (90.8%), lingual varicosity (90.8%), dry mouth (72.3%), atrophic glossitis (32.3%), and numbness of the oral mucosa (30.8%) were the five leading oral manifestations for TT patients. Moreover, TT patients had significantly lower mean hemoglobin level, corpuscular cell volume, Mentzer index, and Green and King index (p < 0.001 for all) as well as significantly higher mean red blood cell count and red blood cell distribution width (p < 0.001 for both) than healthy controls. However, no significant difference in the mean blood iron, total iron binding capacity, vitamin B12, folic acid, or homocysteine levels was discovered between 65 TT patients and 130 healthy controls.. TT patients have specific oral manifestations and a particular blood profile compared to normal individuals.

Topics: Adult; Aged; Aged, 80 and over; Atrophy; Case-Control Studies; Erythrocyte Count; Erythrocyte Indices; Female; Folic Acid; Glossitis; Hemoglobins; Homocysteine; Humans; Hypesthesia; Iron; Male; Middle Aged; Mouth Mucosa; Thalassemia; Tongue; Varicose Veins; Vitamin B 12; Xerostomia; Young Adult

Few modifiable risk factors are known to be associated with the presence and progression of diabetic polyneuropathy (DPN).. We have analyzed in 405 type 2 diabetic (T2DM) subjects (169 women) the association of plasma homocysteine with the presence of DPN measured with the Semmes-Weinstein (SW) monofilament test. A score below 4 was considered an altered SW monofilament test. Plasma homocysteine, vitamin B12 and folic acid were measured using standard procedures (ELISA).. Patients with T2DM with altered SW test have significantly higher age, evolution of disease, HbA1c and lower creatinine clearance values. In addition, plasma homocysteine values were independently and significantly higher in T2DM with DPN measured as altered SW test (13.64 ± 4.93 vs. 12.22 ± 4.48 μmol/l, P<.01) with similar vitamin B12 and folic acid values comparing the 2 groups.. Plasma homocysteine and HbA1c values are the 2 modifiable biological factors associated with the presence of DPN evaluated as an altered SW monofilament test in T2DM subjects.

Topics: Age Factors; Aged; Alcohol Drinking; Cardiovascular Diseases; Case-Control Studies; Creatinine; Diabetes Mellitus, Type 2; Diabetic Neuropathies; Disease Progression; Female; Folic Acid; Glycated Hemoglobin; Homocysteine; Humans; Hyperhomocysteinemia; Hypesthesia; Hypoglycemic Agents; Hypolipidemic Agents; Male; Middle Aged; Overweight; Physical Examination; Risk Factors; Severity of Illness Index; Smoking; Vitamin B 12

Among 141 consecutive patients with neuro-psychiatric abnormalities due to cobalamin deficiency, we found that 40 (28 percent) had no anemia or macrocytosis. The hematocrit was normal in 34, the mean cell volume was normal in 25, and both tests were normal in 19. Characteristic features in such patients included paresthesia, sensory loss, ataxia, dementia, and psychiatric disorders; longstanding neurologic symptoms without anemia; normal white-cell and platelet counts and serum bilirubin and lactate dehydrogenase levels; and markedly elevated serum concentrations of methylmalonic acid and total homocysteine. Serum cobalamin levels were above 150 pmol per liter (200 pg per milliliter) in 2 patients, between 75 and 150 pmol per liter (100 and 200 pg per milliliter) in 16, and below 75 pmol per liter (100 pg per milliliter) in only 22. Except for one patient who died during the first week of treatment, every patient in this group benefited from cobalamin therapy. Responses included improvement in neuropsychiatric abnormalities (39 of 39), improvement (often within the normal range) in one or more hematologic findings (36 of 39), and a decrease of more than 50 percent in levels of serum methylmalonic acid, total homocysteine, or both (31 of 31). We conclude that neuropsychiatric disorders due to cobalamin deficiency occur commonly in the absence of anemia or an elevated mean cell volume and that measurements of serum methylmalonic acid and total homocysteine both before and after treatment are useful in the diagnosis of these patients.

Topics: Adolescent; Adult; Aged; Anemia; Anemia, Megaloblastic; Ataxia; Erythrocyte Indices; Erythrocytes; Female; Hematocrit; Homocysteine; Humans; Hypesthesia; Iron; Male; Methylmalonic Acid; Middle Aged; Nervous System Diseases; Neurocognitive Disorders; Paresthesia; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Adult; Alcoholism; Folic Acid; Humans; Hypesthesia; Muscle Cramp; Neural Conduction; Polyneuropathies; Reflex, Abnormal; Sensation; Thiamine; Vitamin B 12