Department of neurology , Kings College hospital in London , England

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Multiple sclerosis associated with vitamin B12 deficiency.

Reynolds EH, Linnell JC, Faludy JE.

Department of Neurology, King's College Hospital, London, England.

We describe 10 patients with a previously unreported, to our

knowledge, association of multiple sclerosis and unusual vitamin B12

deficiency. The clinical features and the age at presentation were

typical of multiple sclerosis, with eight cases occurring before age

40 years, which is a rare age for vitamin B12 deficiency. Nine

patients had hematologic abnormalities, but only two were anemic. All

six patients examined had low erythrocyte cobalamin levels. Only two

patients had pernicious anemia; in the remaining patients the vitamin

B12 deficiency was unexplained. A vitamin B12 binding and/or

transport is suspected. The nature of the association of multiple

sclerosis and vitamin B12 deficiency is unclear but is likely to be

more than coincidental. Further studies of vitamin B12 metabolism,

binding, and transport in multiple sclerosis are indicated, as these

cases may offer a clue to the understanding of a still mysterious

neurologic disorder.