Particularitățile manifestărilor neurologice ale deficitului de vitamina B12 la pacienții vârstnici: studiu de caz
DOI:
https://doi.org/10.52556/2587-3873.2025.2(104).35Cuvinte cheie:
vitamina B12, anemie megaloblastică, mielozăfuniculară, vârstnici, tulburări neurologiceRezumat
Deficitul vitaminei B12 este o cauză frecvent neglijată a anemiei megaloblastice și a afecțiunilor neurologice, în special în rândul populației în etate. Manifestările clinice pot varia de la simptome hematologice ușoare până la tulburări neuropsihiatrice severe. Sunt prezentate două cazuri clinice cu anemie severă mixtă și manifestări neurologice. Diagnosticul a fost confirmat clinic și paraclinic, necesitând implicare multidisciplinară. Ambii pacienți au prezentat nivele scăzute ale vitaminei B12 și manifestări compatibile cu mieloza funiculară: parestezii, tulburări de mers, instabilitate posturală, slăbiciune musculară și afectare cognitivă. S-a inițiat tratamentul parenteral cu vitamina B12, preparate de fier și acid folic, care au dus la ameliorarea parametrilor hematologici cu recuperare neurologică parțială. Deficitul de vitamina B12 la pacienții vârstnici poate determina sindroame neurologice severe chiar în absența modificărilor hematologice tipice. Diagnosticul precoce și tratamentul adecvat sunt esențiale pentru prevenirea complicațiilor ireversibile. Se recomandă screeningul anual la persoanele în etate și monitorizarea atentă a cazurilor cu factori de risc pentru malabsorbție.
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