Primary Neurologic Symptoms: Have You Considered Pernicious Anemia?

Yocum, Andrew; Patel, Mayuri; Palocko, Bradley; Simon, Erin L.

doi:10.1016/j.jemermed.2022.10.024

The Journal of Emergency Medicine

2023

DOI: 10.1016/j.jemermed.2022.10.024

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Primary Neurologic Symptoms: Have You Considered Pernicious Anemia?

Andrew Yocum¹,

Mayuri Patel²,

Bradley Palocko³

et al.

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Cited by 2 publications

References 11 publications

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Management of vitamin B12 deficiency in primary care

Arganda

2023

Practice Nursing

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Vitamin deficiencies are a major global health concern, and are a particular risk to infants, children and pregnant women. This article discusses what primary care nurses need to know when consulting a patient with a suspected deficiency Vitamin B12 is an essential water-soluble vitamin, which is vital in the production of red blood cells, nervous system function, and DNA synthesis during cell division. Vitamin B12 deficiency is a condition resulted from inadequate intake or malabsorption of vitamin B12. Severe B12 deficiency could lead to pernicious anaemia, mental impairment, and neurological disorders. Therefore, careful management and treatment are pivotal. This deficiency is commonly treated with B12 injections in Primary Care. However, review of literature showed that oral B12 supplementation was as effective as parenteral treatment. To minimise ambiguity in administering B12 injections, several clinical guidelines were highlighted. Nevertheless, further research is needed to evaluate the effectiveness of oral B12 therapy.

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Management of vitamin B12 deficiency in primary care

Arganda

2023

Practice Nursing

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Identifying the Genetic Associations Between Diabetes Mellitus and the Risk of Vitiligo

Zhao,

Hu,

2024

CCID

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Purpose While increasing observational studies have suggested an association between diabetes mellitus (DM) and vitiligo, the causal relationship and possible mechanism remain unclear. Methods Publicly accessible genome-wide association study (GWAS) was utilized to conduct a bidirectional two-sample Mendelian randomization (MR) analysis. GWAS data for diabetes and vitiligo were obtained from the UK Biobank Consortium (20203 cases and 388756 controls) and the current GWAS data with largest cases (GCST004785, 4680 cases and 39586 controls) for preliminary analysis, respectively. Inverse variance weighting (IVW) was used as the main analysis method. Several sensitivity analyses were utilized to test the pleiotropy or heterogeneity. To explore the possible mechanism of gene-generating effects represented by the final instrumental variables in the analysis, enrichment analysis was conducted using the DAVID and STRING database. Results IVW method showed a significant genetic causal association between DM and vitiligo (OR = 1.20, 95% CI: 1.08–1.33, P IVW = 0.0009). Diabetes subtype analysis showed that T2D (type 2 diabetes) were associated with an increased risk of vitiligo (OR = 1.13, 95% CI: 1.00–1.27, P IVW = 0.0432). Sensitivity analysis further confirmed the robustness of the results. The enrichment analysis revealed that the genetic inducing effects of diabetes mellitus on vitiligo were primarily about pancreatic secretion and protein digestion and absorption pathway. Conclusion Our findings provide genetic evidence that there is a notable association between T2D and an elevated risk of vitiligo in European populations. This result may explain why the co-presentation of T2D and vitiligo is often seen in observational studies, and emphasize the significance of vigilant monitoring and clinical evaluations for vitiligo in individuals diagnosed with T2D. The aberrant glucose and lipid metabolism and the primary nutrient absorption disorder of vitiligo brought on by diabetes may be the potential mechanisms behind this association.

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Primary Neurologic Symptoms: Have You Considered Pernicious Anemia?

Cited by 2 publications

References 11 publications

Management of vitamin B12 deficiency in primary care

Management of vitamin B12 deficiency in primary care

Identifying the Genetic Associations Between Diabetes Mellitus and the Risk of Vitiligo

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