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
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