Case Report - An interesting case of reversible myelopathy with megaloblastic anemia due to tropical sprue

Vitamin B12 deficiency is common, with most patients lacking classical features of advanced, severe deficiency. Early diagnosis and treatment can prevent severe anemia and irreversible damage to the nervous system. We describe a 31-year-old with megaloblastic anemia who presented with clinical and radiological features of early myelopathy and low serum levels of vitamin B 12. Further evaluation led to a diagnosis of tropical sprue causing megaloblastic anemia and treatment with cyanocobalamin injections led to rapid resolution of clinical manifestations and magnetic resonance imaging abnormalities. We have reviewed the literature of magnetic resonance imaging in vitamin B 12 deficiency myelopathy and discussed the issues related to diagnosis and early treatment of this potentially reversible condition