Voukelatou, P., Vrettos, I. and Kalliakmanis, A. (2016) Neurologic Symtoms as the Only Manifestation of B12 Deficiencyin a Patient with Normal Hematocrite, MCV, Peripheral Blood Smear and Homocysteine Levels. Oxford Medical Case Reports, 2016, Article No. omw091.
https://doi.org/10.1093/omcr/omw091

has been cited by the following article:

• TITLE: Biermer Disease in an Unusual Neurological Presentation without Anemia: A Case Report

  AUTHORS: Nsenga Djapa Guy Roger, Fogang Fogoum Yannick, Ndjitoyap Ndam Antonin Wilson, Kowo Pierre Mathurin, Ankouane Andoulo Firmin, Choukem Simon Pierre

  KEYWORDS: Biermer Disease, Pernicious Anemia, Autoimmune Disease, Atrophic Gastritis, Vitamin B12 Deficiency, Cameroon

  JOURNAL NAME: Open Journal of Gastroenterology, Vol.12 No.5, May 31, 2022

  ABSTRACT: Background: Biermer disease is a megaloblastic disease caused by vitamin B12 deficiency. It is a rare clinical entity especially in subsahara Africa. Case presentation: We report the case of a 45 years old female patient who consulted for a one month history of generalised muscle cramps, weakness and numbness of all four limbs. Physical examination was relevant for a poor gait, poor coordination of both upper and lower limbs, a positive Romberg sign, normal muscle tone in all four limbs, reduced pallesthesia and deep tendon reflexes, abolished plantar reflexes. Paraclinical investigations revealed macrocytosis without anemia, a low cyanocobalamin (vitamin B12) level with a normal folic acid level, an atrophic corporeofundic mucosa which upon pathological analysis revealed a chronic atrophic gastritis with no Helicobacter pylori infection. Anti-intrinsic factor antibodies were positive while anti parietal cells antibodies were negative. The diagnosis of Biermer disease was considered and the patient did well on vitamin B12 supplementation. Conclusion: Though a rare disease, Biermer disease should be considered in a patient who consults for polyneuropathy even in the absence of anemia.