Syncope due to vitamin-B12 deficiency - case report.

Q3 Medicine
Josef Finsterer
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Abstract

To our knowledge, a patient with recurrent syncope due to vitamin B12 deficiency without hematologic manifestations has not been reported before. We present the case of an 83-year-old man who experienced a third episode of syncope, characterized by sudden loss of consciousness without convulsions and rapid recovery. His medical history included ischemic stroke 22 years earlier and multiple bowel resections following cholecystectomy 21 years ago. The examination revealed a severe vitamin B12 deficiency and bradycardia on ECG. The examination for heart disease was inconclusive. The syncope was attributed to a vitamin B12 deficiency and consecutive cardiac autonomic neuropathy (CAN) after other causes for the syncope were sufficiently ruled out. Syncopes did not recur after adequate vitamin B12 supplementation. This case illustrates that partial bowel resection may lead to severe vitamin B12 deficiency, which can result in CAN. Disturbed autonomic innervation of the cardiac conduction system can lead to bradycardia, which, in turn, can result in syncope. Patients with a history of complete or partial bowel resection should undergo regular monitoring of vitamin B12 levels to prevent potentially symptomatic deficiency.

维生素b12缺乏导致晕厥1例报告。
据我们所知,因维生素B12缺乏而复发性晕厥无血液学表现的病例尚未见报道。我们提出的情况下,83岁的男子谁经历了第三次发作晕厥,其特点是突然失去意识,没有抽搐和迅速恢复。他的病史包括22年前缺血性中风和21年前胆囊切除术后多次肠切除术。检查发现严重的维生素B12缺乏和心电图心动过缓。心脏病的检查没有结果。在充分排除晕厥的其他原因后,晕厥归因于维生素B12缺乏和连续的心脏自主神经病变(CAN)。补充足够的维生素B12后,晕厥没有再发生。本病例说明部分肠切除术可能导致严重的维生素B12缺乏,从而导致can。心脏传导系统的自主神经支配紊乱可导致心动过缓,而心动过缓又可导致晕厥。有完全或部分肠切除术史的患者应定期监测维生素B12水平,以预防潜在的症状性缺乏。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of Medicine and Life
Journal of Medicine and Life Medicine-Medicine (all)
CiteScore
1.90
自引率
0.00%
发文量
202
期刊介绍: The Journal of Medicine and Life publishes peer-reviewed articles from various fields of medicine and life sciences, including original research, systematic reviews, special reports, case presentations, major medical breakthroughs and letters to the editor. The Journal focuses on current matters that lie at the intersection of biomedical science and clinical practice and strives to present this information to inform health care delivery and improve patient outcomes. Papers addressing topics such as neuroprotection, neurorehabilitation, neuroplasticity, and neuroregeneration are particularly encouraged, as part of the Journal''s continuous interest in neuroscience research. The Editorial Board of the Journal of Medicine and Life is open to consider manuscripts from all levels of research and areas of biological sciences, including fundamental, experimental or clinical research and matters of public health. As part of our pledge to promote an educational and community-building environment, our issues feature sections designated to informing our readers regarding exciting international congresses, teaching courses and relevant institutional-level events.
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