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Rapid healing of a patient with dramatic subacute combined degeneration of spinal cord: a case report

Overview of attention for article published in BMC Research Notes, January 2017
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Title
Rapid healing of a patient with dramatic subacute combined degeneration of spinal cord: a case report
Published in
BMC Research Notes, January 2017
DOI 10.1186/s13104-016-2344-4
Pubmed ID
Authors

Florian C. Roessler, Stephanie Wolff

Abstract

Prevalence of cobalamin deficiency is high especially in older patients and an immediate therapy start is necessary to prevent irreversible neurological damages. Unfortunately, the diagnosis of cobalamin deficiency is difficult and at present, there is no consensus for diagnosis of this deficiency. Therefore, we aim to elucidate a meaningful diagnostic pathway by a case report with an initially misleading medical history. A 57 year-old Caucasian man suffering from dramatic myelosis of the cervical posterior columns. Apart from associated neurological symptoms (tactile hypaesthesia, reduced vibration sensation, loss of stereognosis and of two-point-discrimination) there were no further complaints; especially no gastrointestinal, haematological or psychiatric disorders were provable. Cobalamin (vitamin B12) serum level was normal. The diagnosis of subacute combined degeneration of spinal cord was confirmed by an elevated methylmalonic acid, and hyperhomocysteinemia. Cobalamin deficiency was caused by asymptomatic chronic atrophic inflammation of the stomach with a lack of intrinsic factor producing gland cells. This was revealed by increased gastrin and parietal cell antibodies and finally confirmed by gastroscopy. Parenteral substitution of cobalamin rapidly initiated regeneration. This case demonstrates that normal cobalamin serum levels do not rule out a cobalamin deficiency. In contrast, path-breaking results can be achieved by determining homocysteine, holotranscobalamin, and methylmalonic acid.

Twitter Demographics

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Mendeley readers

The data shown below were compiled from readership statistics for 16 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 16 100%

Demographic breakdown

Readers by professional status Count As %
Student > Bachelor 4 25%
Student > Master 3 19%
Lecturer 1 6%
Other 1 6%
Lecturer > Senior Lecturer 1 6%
Other 3 19%
Unknown 3 19%
Readers by discipline Count As %
Medicine and Dentistry 5 31%
Neuroscience 2 13%
Nursing and Health Professions 2 13%
Immunology and Microbiology 1 6%
Agricultural and Biological Sciences 1 6%
Other 1 6%
Unknown 4 25%

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 25 April 2018.
All research outputs
#13,983,593
of 18,204,576 outputs
Outputs from BMC Research Notes
#2,432
of 3,789 outputs
Outputs of similar age
#267,852
of 398,027 outputs
Outputs of similar age from BMC Research Notes
#207
of 305 outputs
Altmetric has tracked 18,204,576 research outputs across all sources so far. This one is in the 20th percentile – i.e., 20% of other outputs scored the same or lower than it.
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We're also able to compare this research output to 305 others from the same source and published within six weeks on either side of this one. This one is in the 28th percentile – i.e., 28% of its contemporaries scored the same or lower than it.