A 50-year-old female with dysuria, dysporia, numbness and weakness of extremities

Abstract

This paper reports one patient, with a history of autoimmune gastritis, who presented dysuria and dysporia for 5 years, weakness of left upper limb for one and a half years, and numbness and weakness of extremities for 2 months. The patient’s symptoms were attributed to both vitamin B12 and copper deficiency myelopathy. Copper deficiency myelopathy (CDM) represents a treatable myelopathy which is highly similar to subacute combined degeneration due to vitamin B12 deficiency. Patients with both copper and vitamin B12 deficiency myelopathy were rare and should be considered in the differential diagnosis. It is crucial to evaluate concentration of serum copper and vitamin B12 simultaneously on patients with anaemia, sensory ataxia, paraesthesia and weakness of limbs. The spinal MRI usually showed high T2-weighted signal in the posterior and lateral cervical and/or thoracic cord. The patient in this report showed a significant clinical improvement of anaemia and weakness after copper and vitamin B12 supplementation therapy. DOI: 10.3969/j.issn.1672-6731.2015.03.016

Keywords

• Subacute combined degeneration
• Vitamin B12
• Copper
• Case reports