Localised Skin Hyperpigmentation as a Presenting Symptom of Vitamin B12 Defciency Complicating Chronic Atrophic Gastritis
Journal Title: Sultan Qaboos University Medical Journal - Year 2015, Vol 15, Issue 3
Abstract
Vitamin B 12 defciency is common in developing countries and should be suspected in patients with unexplained anaemia or neurological symptoms. Dermatological manifestations associated with this defciency include skin hyper- or hypopigmentation, angular stomatitis and hair changes. We report a case of a 28-year-old man who presented to the Sultan Qaboos University Hospital in Muscat, Oman, in November 2013 with localised hyperpigmentation of the palmar and dorsal aspects of both hands of two months’ duration. Other symptoms included numbness of the hands, anorexia, weight loss, dizziness, fatigability and a sore mouth and tongue. Tere was no evidence of hypocortisolaemia and a literature search revealed a possible B12 defciency. Te patient had low serum B 12 levels and megaloblastic anaemia. An intrinsic factor antibody test was negative. A gastric biopsy revealed chronic gastritis. After B12 supplementation, the patient’s symptoms resolved. Family physicians should familiarise themselves with atypical presentations of B12 defciency. Many symptoms of this defciency are reversible if detected and treated early.
Authors and Affiliations
Kawther El-Shafe| Department of Family Medicine & Public Health, Sultan Qaboos University Hospital, Nafsa Samir| Department of Family Medicine & Public Health, Sultan Qaboos University Hospital, Ritu Lakhtakia| Department of Pathology, College of Medicine & Health Sciences, Sultan Qaboos University, Muscat, Oman, Robin Davidson| Department of Family Medicine & Public Health, Sultan Qaboos University Hospital, Ahmed Al-Waili| Department of Family Medicine & Public Health, Sultan Qaboos University Hospital, Muna Al-Mamary| Department of Family Medicine & Public Health, Sultan Qaboos University Hospital, Mohammed Al-Shafee| Department of Family Medicine, Oman Medical College, Sohar, Oman
Keywords
Related Articles
- EP ID EP14592
- DOI -
- Views 324
- Downloads 13
Minimal stimulation protocol: a cheap and effective method of ovulation induction
– To determine the effectiveness and cost of Minimal Stimulation Protocol (MSP), a new combination of human menopausal gonadotrophin (hMG) and clomiphene citrate (CC), for controlled ovarian hyperstimulation...
Laboratory Studies on the Prevalence and Cercarial Rhythms of Trematodes from Bulinus truncatus and Biomphalaria Pfeifferi Snails from Khartoum State, Sudan
ObjectiveS: (a) To determine the natural infection rate of Bulinus truncatus and Biomphalaria pfeifferi snails with trematodes’ cercariae. (b) To determine the emergence and rhythmicity of cercariae. (c) To elucidate...
Calvarial Tuberculosis in a Preschool-Aged Child An uncommon entity
Calvarial tuberculosis is a rare manifestation of tuberculosis, especially in children under fve years of age. We report a two-and-a-half-year-old male child who presented to the Nilratan Sircar Medical College, Kolkat...
Knowledge, Practice and Self-Effcacy in Evidence-Based Practice among Midwives in East Iran
Objectives: Te successful implementation of evidence-based practice (EBP) can lead to appropriate and effective midwifery care during pregnancy, childbirth and in the postnatal period. However, levels of knowledge and...
Bilateral Absence of the Arcuate Artery on the Dorsum of the Foot With anomalous origin of dorsal metatarsal arteries
Bilateral absence of the arcuate artery was observed during routine dissection of the lower limbs of a 60-year-old male cadaver. Running distally on the dorsal aspect of both feet and opposite the tarso-metatarsal joint...