“NON NEUROLOGICALMANIFESTATIONS OF VITAMIN B12 DEFICIENCY”

Background:Vitamin B12 deficiecy may present with a variety of non specific, non neurological manifestations like the involvement of, skin, hair, mucous membrane and hematological systems, which may antedate the neurological symptoms by years! There are few reported cases in literature about the same. Aiims: The present study aimed to evaluate and analyse the various nonneurological manifestations in patients of vitamin B12 deficiency presenting with various neurological manifestations. Material& Method: Forty patients presenting clinically with evidence of neuropathy, myelopathy, optic neuropathy, dementia, neuropsychiatric manifestations, and cerebellar ataxia, either alone or in combination with serum vitamin B12 level <200 pg/ml or a megaloblastic bone marrow or both were included. The non neurological manifestations were were then critically analysed Results: Anaemia was the commonest manifestation seen in 60%, followed by premature graying of hair with hair fall in 45%, glossitis in 15%, jaundice in 10% and. hyperpigmentation, vitiligo& retinal haemorrhage seen in 5% each . A significant correlation was seen (p2 years for premature graying of hair with hair fall, hyperpigmentation, vitiligo& retinal haemorrhage. Except vitiligo,there was a complete resolution of all symptoms within 3-4 months of injectable B12 therapy. Conclusions: Thusthisstudy highlights the importance of various non neurological manifestation of B12 deficiency which may preceed the neurological diagnosis by years. As these manifestations are not specific for B12 deficiency a high index of suspicion is required so that a potentially treatable cause may not be missed!