TY - JOUR
T1 - Localised skin hyperpigmentation as a presenting symptom of vitamin B12 deficiency complicating chronic atrophic gastritis
AU - El-Shafie, Kawther
AU - Samir, Nafisa
AU - Lakhtakia, Ritu
AU - Davidson, Robin
AU - Al-Waili, Ahmed
AU - Al-Mamary, Muna
AU - Al-Shafee, Mohammed
N1 - Publisher Copyright:
© 2015, Sultan Qaboos University. All rights reserved.
PY - 2015
Y1 - 2015
N2 - Vitamin B12 deficiency is common in developing countries and should be suspected in patients with unexplained anaemia or neurological symptoms. Dermatological manifestations associated with this deficiency 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. There was no evidence of hypocortisolaemia and a literature search revealed a possible B12 deficiency. The patient had low serum B12 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 deficiency. Many symptoms of this deficiency are reversible if detected and treated early.
AB - Vitamin B12 deficiency is common in developing countries and should be suspected in patients with unexplained anaemia or neurological symptoms. Dermatological manifestations associated with this deficiency 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. There was no evidence of hypocortisolaemia and a literature search revealed a possible B12 deficiency. The patient had low serum B12 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 deficiency. Many symptoms of this deficiency are reversible if detected and treated early.
KW - Atrophic gastritis
KW - Case report
KW - Hyperpigmentation
KW - Oman
KW - Vitamin B12 deficiency
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U2 - 10.18295/squmj.2015.15.03.019
DO - 10.18295/squmj.2015.15.03.019
M3 - Article
C2 - 26357561
AN - SCOPUS:84940020503
SN - 2075-051X
VL - 15
SP - e420-e423
JO - Sultan Qaboos University Medical Journal
JF - Sultan Qaboos University Medical Journal
IS - 3
ER -