This Article  • References  • Full text PDF  • Reply to article  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Social Bookmarking   What's this?

E. H. Reynolds, FRCP; J. C. Linnell, PhD; J. E. Faludy, MSc; T. Bottiglieri, MSc
King's College Hospital Denmark Hill London SE5 9RS United Kingdom

Arch Neurol. 1992;49(7):683-684.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

In Reply.

—We thank Goodkin and colleagues for their interest in our article¹ on 10 patients with multiple sclerosis (MS) associated with vitamin B₁₂ deficiency, and we agree with their view that the serum vitamin B₁₂ assay may be an unreliable guide to a vitamin B₁₂ deficiency state. Indeed, not only may some patients with a low serum vitamin B₁₂ level not have a vitamin B₁₂ deficiency but others with vitamin B₁₂ levels above 200 pg/mL may be severely deficient.² For example, we have studied one patient with a high serum vitamin B₁₂ level (greater than 2000 pg/mL) who had subacute combined degeneration related to a severe vitamin B₁₂ deficiency state, as reflected in a megaloblastic anemia, low red blood cell vitamin B₁₂ level, high plasma homocysteine level, and hematologic and neurologic response to vitamin B₁₂ treatment.³ . . . [Full Text PDF of this Article]

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?