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- $Unique_ID{BRK04313}
- $Pretitle{}
- $Title{Vitamin B12 Deficiency}
- $Subject{Vitamin B12 Deficiency Cobalamin Deficiency Anemia, Pernicious
- Burning Mouth Syndrome (Burning Tongue Syndrome; Oral Galvanism; Glossodynia;
- Glossopyrosis; Stomatodynia; Stomatopyrosis) }
- $Volume{}
- $Log{}
-
- Copyright (C) 1988, 1989, 1992 National Organization for Rare Disorders,
- Inc.
-
- 541:
- Vitamin B12 Deficiency
-
- ** IMPORTANT **
- It is possible the main title of the article (Vitamin B12 Deficiency) is
- not the name you expected. Please check the SYNONYMS listing on the next
- page to find alternate names and disorder subdivisions covered by this
- article.
-
- Synonyms
-
- Cobalamin Deficiency
-
- Information on the following disorders may be found in the Related
- Disorders section of this report:
-
- Anemia, Pernicious
- Burning Mouth Syndrome (Burning Tongue Syndrome; Oral Galvanism;
- Glossodynia; Glossopyrosis; Stomatodynia; Stomatopyrosis)
-
- General Discussion
-
- ** REMINDER **
- The information contained in the Rare Disease Database is provided for
- educational purposes only. It should not be used for diagnostic or treatment
- purposes. If you wish to obtain more information about this disorder, please
- contact your personal physician and/or the agencies listed in the "Resources"
- section of this report.
-
-
- Vitamin B12 Deficiency is characterized by an abnormally low level of
- this vitamin in the blood. The disorder can be caused by a poor diet,
- inadequate absorption or utilization of B12 such as following stomach and
- intestinal surgery and increase in certain intestinal organisms. The
- deficiency causes changes in the blood and the central nervous system.
- Injection of this vitamin usually cures the disorder if the underlying cause
- can be corrected.
-
- Symptoms
-
- Symptoms of Vitamin B12 Deficiency usually appear years after absorption of
- this vitamin ceases, because the amount of B12 needed by the body is tiny,
- and a large amount is usually stored in the liver. In most patients, a low
- red blood cell count (anemia) develops gradually and progressively as the
- stores of Vitamin B12 in the liver are used up. Patients may not be alerted
- to the deficiency because of its slow development. Occasionally the spleen
- and liver may become enlarged (hepatosplenomegaly). Patients with this
- deficiency may also have various gastrointestinal symptoms such as a lack of
- appetite (anorexia), intermittent constipation and diarrhea, and poorly
- localized abdominal pain. An inflamed tongue (glossitis), usually described
- as "burning of the tongue", may be an early symptom of Vitamin B12
- Deficiency. Considerable weight loss is common.
-
- Nervous System:
- The nervous system may be involved, even in the absence of anemia. Most
- commonly, the nerves outside the brain and spinal cord (peripheral nerves)
- are involved. The spinal cord may be involved, beginning with loss of
- vibratory sensation in the lower extremities, loss of position sense and loss
- of muscle coordination (ataxia). Later, spasticity, exaggerated reflexes,
- and upward flexing of the big toe upon stimulating the sole of the foot
- (Babinski reflex) follows. Some patients with Vitamin B12 Deficiency also
- get irritated easily, have mild depressions, or actual paranoia
- (megaloblastic madness). Rarely, yellow-blue color blindness may occur.
-
- Causes
-
- Vitamin B12 Deficiency is caused by decreased absorption of this vitamin. It
- is most often due to pernicious anemia which causes the mucous lining of the
- stomach to fail to secrete the so-called "intrinsic factor" which is needed
- for vitamin B12 absorption. The surgical removal of part or all of the
- stomach (gastrectomy), and chronic infection causing wasting of the stomach
- may also cause deficient secretion of intrinsic factor. Deficiency of
- certain endocrine glands (especially thyroid and adrenal glands) if they are
- associated with pernicious anemia, suggest an autoimmune basis for
- underdevelopment of stomach mucous membrane. Autoimmune disorders are caused
- when the body's natural defenses (antibodies) against invading organisms, for
- unknown reasons, attack healthy tissue.
-
- Affected Population
-
- Vitamin B12 Deficiency affects males and females in equal numbers.
-
- Related Disorders
-
- Symptoms of the following disorders can be similar to those of Vitamin B12
- Deficiency or may be associated with it. Comparisons may be useful for a
- differential diagnosis:
-
- Pernicious Anemia is a disorder resulting from an impaired absorption of
- vitamin B-12, a necessary co-factor in the production of red blood cells.
- Pernicious Anemia develops slowly because the liver stores enough vitamin B-
- 12 to last 3 to 5 years. The abnormally low number of red blood cells
- (anemia) may produce weakness, easy fatigability, shortness of breath
- (dyspnea), an abnormally rapid heart beat (tachypnea) and angina. Possible
- gastrointestinal problems are similar to those of Vitamin B-12 Deficiency.
- (For more information, choose "Pernicious Anemia as your search term in the
- Rare Disease Database.)
-
- Burning Mouth Syndrome (Burning Tongue Syndrome) is characterized by a
- burning sensation in the mouth and/or the tongue. There is no obvious
- clinical evidence of inflammation, although a Candida albicans infection can
- be a cause. The cause of most cases Burning Mouth Syndrome, when it is not
- associated with Vitamin B12 Deficiency, is unknown. Many causes have been
- suggested by researchers, including allergic reactions to pollen, cereals,
- metals and materials used in the manufacture of dentures. Burning Tongue may
- be an early symptom of Vitamin B-12 Deficiency. (For more information,
- choose "Burning Mouth Syndrome" as your search term.)
-
- Therapies: Standard
-
- Treatment for the anemia of Vitamin B12 Deficiency consists of intramuscular
- injections of vitamin B12 until the blood and neurologic abnormalities are
- cleared up. Oral iron therapy is prescribed if an iron deficiency is also
- diagnosed.
-
- If the underlying mechanism of Vitamin B12 Deficiency is known, this
- should be corrected.
-
- Therapies: Investigational
-
- The National Institute of Arthritis, Musculoskeletal and Skin Diseases is
- looking for patients with various kinds of Ichthyosis willing to participate
- in research aimed at mapping the genes responsible for their disorder.
- Interested persons may contact:
-
- Dr. Sherri Bale
- National Institute of Arthritis, Musculoskeletal and Skin Diseases
- 9000 Rockville Pike
- Bethesda, MD 20892
- (301) 402-2679
-
- This disease entry is based upon medical information available through
- January 1992. Since NORD's resources are limited, it is not possible to
- keep every entry in the Rare Disease Database completely current and
- accurate. Please check with the agencies listed in the Resources section for
- the most current information about this disorder.
-
- Resources
-
- For more information on Vitamin B12 Deficiency, please contact:
-
- National Organization for Rare Disorders (NORD)
- P.O. Box 8923
- New Fairfield, CT 06812-1783
- (203) 746-6518
-
- Cobalamin Network
- P.O. Box 174
- Thetford Center, VT 05075
- (802) 785-4029 (after 8:00 p.m. EST)
-
- National Digestive Diseases Information Clearinghouse
- Box NDIC
- Bethesda, MD 20892
- (301) 468-2162
-
- NIH/National Heart, Blood & Lung Institute
- Office of Public Inquiries
- 9000 Rockville Pike
- Bethesda, MD 20892
- (301) 496-4236
-
- References
-
- INTERNAL MEDICINE, 2nd ed.: Jay H. Stein, et al., eds.; Little, Brown,
- 1987. Pp. 1039-1040.
-
- ISOTOPE-DILUTION ASSAY FOR URINARY METHYLMALONIC ACID IN THE DIAGNOSIS OF
- VITAMIN B12 DEFICIENCY. A PROSPECTIVE CLINICAL EVALUATION: D.B. Matchar, et
- al.; Ann Intern Med (May 1987: issue 106(5)). Pp. 707-710.
-
- MEGALOBLASTIC ANAEMIA IN A VEGETARIAN HINDU COMMUNITY: I. Chanarin, et
- al.; Lancet (November 23, 1985: issue 2(8465)). Pp. 1168-1172.
-
- PRENATAL VITAMIN B12 THERAPY OF A FETUS WITH METHYLCOBALAMIN DEFICIENCY
- (COBALAMIN E DISEASE): D.S. Rosenblatt, et al.; Lancet (May 18, 1985: issue
- (8)).
-
- PHYSICIAN RESPONSE TO LOW SERUM COBALAMIN LEVELS: R. Carmel, et al.;
- Arch Intern Med (June 1986: 146(6)). Pp. 1161-1165.
-
-