Primary progressive multiple sclerosis to be treated with ocrelizumab: A mistaken case of cobalamin deficiency

Sydney Feldman, Salman Aljarallah, Shiv Saidha

Research output: Contribution to journalArticle

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 languageEnglish (US)
Article numbere229080
JournalBMJ case reports
Volume12
Issue number5
DOIs
StatePublished - May 14 2019

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ocrelizumab
Chronic Progressive Multiple Sclerosis
Vitamin B 12
Multiple Sclerosis
Vitamin B 12 Deficiency
Neurologic Manifestations
Nervous System Diseases
Spine
B-Lymphocytes
Monoclonal Antibodies

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 journalArticle

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