Subacute Combined Degeneration of spinal cord with megaloblastic anemia secondary to vitamin B12 deficiency in a 17-year female

Subacute Combined Degeneration of spinal cord with megaloblastic anemia secondary to vitamin B12 deficiency in a 17-year female

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Sub acute combined degeneration of spinal cord (SCD), a treatable non-compressive myelopathy, is a rare cause of demyelination of the dorsal and lateral columns of the spinal cord.Megaloblastic anemia is a disorder caused by impaired DNA synthesis and is characterised by a distinctive abnormality in the hematopoietic precursors in the bone marrow in which the maturation of the Left Cover nucleus is delayed relative to that of the cytoplasm.Both this condition are complication of vitamin B12 deficiency, which is reversible if diagnosed and treated early.We present a case of a 17- year-female patient with symptoms of tingling and numbness in both lower limbs and MRI showing relative thinning of dorsal cord from D4 to D10 level with areas of hyperintensity along posterior surface.

A diagnosis of sub acute combined degeneration of the spinal cord was considered and confirmed by laboratory findings especially by blood peripheral smear findings, RBCs indices,bone marrow aspiration cytology and serum vitamin B12.The patient showed complete recovery on B12 therapy.This case is interesting as Vitamin B12 deficiency & neurological presentation in a 17- year young female Facial Mask is uncommon.