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Vitamin B12 deficiency
Other Resources UpToDate PubMed

Vitamin B12 deficiency

Contributors: Joon B. Kim MD, Christine Osborne MD, Marilyn Augustine MD, Susan Burgin MD, Abhijeet Waghray MD
Other Resources UpToDate PubMed

Synopsis

Patients with a vitamin B12 deficiency classically present with megaloblastic anemia, atrophic glossitis, localized or generalized skin pigmentation, neurological changes characterized by symmetrical lower extremity neuropathy greater than upper extremity neuropathy with paresthesia and ataxia that may progress to weakness, spasticity, cerebellar ataxia, and personality changes. Concomitant folate deficiency is often present and may mimic many symptoms of vitamin B12 deficiency.

Vitamin B12, or cobalamin, is a water-soluble vitamin found in meat, fish, and dairy products and, once combined with intrinsic factor in the stomach, is absorbed in the ileum. Patients at risk for vitamin B12 deficiency include those with a lack of intrinsic factor (pernicious anemia) or antibodies to intrinsic factor, malabsorption syndromes (especially those who have had a gastrectomy, gastric bypass, or chronic pancreatitis), or infections such as Helicobacter pylori or tapeworm infections. In addition, strict vegans, older adults, and people with alcohol use disorder are particularly vulnerable to vitamin B12 deficiency. Elderly patients are at risk due to the high prevalence of atrophic gastritis. Patients with autoimmune conditions such as Graves disease, thyroiditis, and vitiligo are also at risk.

Codes

ICD10CM:
E53.8 – Deficiency of other specified B group vitamins

SNOMEDCT:
190634004 – Cobalamin deficiency

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Last Reviewed:01/30/2019
Last Updated:01/30/2019
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Vitamin B12 deficiency
A medical illustration showing key findings of Vitamin B12 deficiency : Fatigue, Oral ulcers, Ataxia, Anemia, Hyperpigmentation
Clinical image of Vitamin B12 deficiency - imageId=7114227. Click to open in gallery.  caption: 'Hyperpigmented palmar macules and prominent pigmentation in palmar creases and over interphalangeal joints.'
Hyperpigmented palmar macules and prominent pigmentation in palmar creases and over interphalangeal joints.
Copyright © 2024 VisualDx®. All rights reserved.