Re: pernicious anemia or MS

Posted By CCF MD mdf on August 30, 1998 at 21:14:58:

In Reply to: pernicious anemia or MS posted by heda on August 30, 1998 at 17:28:30:






6 years ago was diagnosed with MS based on abnormal MRI but evoked potential and lumber puncture were negative.
Last year, it turned out that my diagnosis of pernicious anemia "fell in crack 6 years ago" as told by doctor.
Because my B-12 level was low 6 years ago and he had not paid attention to my low level of B-12.
Schilling test and antibody test confirmed pernicious anemia.  Could B-12 cause abnormal MRI scan.
How probable is it to have both MS and PA?  How probable is it to get new nuro symptoms even though I take B-12 shots monthly?
I am 36 years old male from Middle East. Thanks.
=
MS and PA would have as much chance of occurring together as any other two illnesses - should be just random coincidence.
I have seen B12 deficiency patients whose MRI of the cervical spine showed white matter lesions, and whose symptoms were those of a cervical myelopathy, including the Lhermitte sign. In this circumstance, we often think of MS, but B12 deficiency is always a consideration.
I would recommend B12 replacement. Your doctor will guide you on this, but at first they will be pretty frequent and after a couple of months will taper off to a less frequent schedule. Ultimately they will be monthly, but if you really do have B12 deficiency the shots shouldn't be monthly at first.
I would expect NEW symptoms to not occur once B12 is replaced adequately. Pre-existing symptoms may not resolve.
The treatment of MS and of B12 deficiency is so different that it is important to be sure the diagnosis is right. That is, you may have B12 deficiency that isn't clinically significant and it may really be MS. In that case, it would be a mistake to drop the MS treatment. It's usually NOT harmful to treat with B12 even if you don't need it, so I'd recommend that. I guess I'd just be careful about the certainty of the diagnosis before dropping the MS part of the treatment.
You are certainly welcome to see the specialists at the Mellen Center in the department of neurology at CCF. We have an international office at Cleveland Clinic who work to make your trip to Cleveland as smooth as possible. Call 1-216-444-2000 or if you are in the US, call 800 223 2273 and ask for the international office.
I hope this helps. CCF MD mdf.

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