Abstract
Cobalamin (vitamin B 12) deficiency often manifests with neurologic symptoms and may rarely mimic multiple sclerosis (MS) among other neurological disorders. However, MRI changes associated with cobalamin deficiency are typically spinal predominant and distinct from MS-related changes. We report a case of a patient with cobalamin deficiency who was recommended by her primary neurologist to commence treatment with ocrelizumab, a potent anti-CD20 B-cell depleting monoclonal antibody, after being diagnosed with primary progressive MS. However, cervical spine MRI demonstrated changes classical of cobalamin deficiency including â € inverted V sign' signal hyperintensity and following parenteral cobalamin supplementation her neurological symptoms quickly and dramatically improved.
| Original language | English (US) |
|---|---|
| Article number | e229080 |
| Journal | BMJ case reports |
| Volume | 12 |
| Issue number | 5 |
| DOIs | |
| State | Published - May 14 2019 |
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Keywords
- multiple sclerosis
- vitamins and supplements
ASJC Scopus subject areas
- Medicine(all)
Cite this
Primary progressive multiple sclerosis to be treated with ocrelizumab : A mistaken case of cobalamin deficiency. / Feldman, Sydney; Aljarallah, Salman; Saidha, Shiv.
In: BMJ case reports, Vol. 12, No. 5, e229080, 14.05.2019.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Primary progressive multiple sclerosis to be treated with ocrelizumab
T2 - A mistaken case of cobalamin deficiency
AU - Feldman, Sydney
AU - Aljarallah, Salman
AU - Saidha, Shiv
PY - 2019/5/14
Y1 - 2019/5/14
N2 - Cobalamin (vitamin B 12) deficiency often manifests with neurologic symptoms and may rarely mimic multiple sclerosis (MS) among other neurological disorders. However, MRI changes associated with cobalamin deficiency are typically spinal predominant and distinct from MS-related changes. We report a case of a patient with cobalamin deficiency who was recommended by her primary neurologist to commence treatment with ocrelizumab, a potent anti-CD20 B-cell depleting monoclonal antibody, after being diagnosed with primary progressive MS. However, cervical spine MRI demonstrated changes classical of cobalamin deficiency including â € inverted V sign' signal hyperintensity and following parenteral cobalamin supplementation her neurological symptoms quickly and dramatically improved.
AB - Cobalamin (vitamin B 12) deficiency often manifests with neurologic symptoms and may rarely mimic multiple sclerosis (MS) among other neurological disorders. However, MRI changes associated with cobalamin deficiency are typically spinal predominant and distinct from MS-related changes. We report a case of a patient with cobalamin deficiency who was recommended by her primary neurologist to commence treatment with ocrelizumab, a potent anti-CD20 B-cell depleting monoclonal antibody, after being diagnosed with primary progressive MS. However, cervical spine MRI demonstrated changes classical of cobalamin deficiency including â € inverted V sign' signal hyperintensity and following parenteral cobalamin supplementation her neurological symptoms quickly and dramatically improved.
KW - multiple sclerosis
KW - vitamins and supplements
UR - http://www.scopus.com/inward/record.url?scp=85065818475&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85065818475&partnerID=8YFLogxK
U2 - 10.1136/bcr-2018-229080
DO - 10.1136/bcr-2018-229080
M3 - Article
C2 - 31092497
AN - SCOPUS:85065818475
VL - 12
JO - BMJ Case Reports
JF - BMJ Case Reports
SN - 1757-790X
IS - 5
M1 - e229080
ER -