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