- 期刊
以非自願性體重減輕及拖曳步態為表現之惡性貧血－個案報告
Pernicious Anemia Presenting with Unintentional Weight Loss and Shuffling Gait: A Case Report
摘要
非自願性體重減輕是老年人很常見的臨床表現，除了會造成致病率及致死率的增加，也會導致老年人自理能力及生活品質的下降。常見的原因包括：惡性腫瘤、腸胃道疾病、糖尿病、甲狀腺亢進以及心理疾病，甚至高達四分之一無法找出明確的病因。老年人體重減輕的臨床表現常是多樣化且不易明確診斷的，需要透過完整的病史詢問、詳細的身體理學檢查與評估、以及廣泛的實驗室檢查做鑑別診斷，以釐清可能的成因。我們提出一位71歲男性之惡性貧血患者以顯著體重減輕及拖曳步態為臨床表現，原因是自體免疫性維生素B12缺乏所引起。經過維生素B12注射治療後，舌頭燒燙疼痛感導致進食困難與食慾不振及拖曳步態均顯著改善，而且紅血球、血紅素、平均血球容積及體重皆逐漸回復至正常範圍。
並列摘要
Apart from increased morbidity and mortality, unintentional weight loss (UWL) as a common clinical problem in older adults may impair activities of daily living and quality of life. The most common etiologies include malignancy, nonmalignant gastrointestinal disease, diabetes, hyperthyroidism, and psychiatric conditions. However, there is no identifiable causes of UWL in up to one-quarter of the elderly population. As clinical presentations can be varied and confusing, comprehensive review of medical history, thorough physical examination, various laboratory tests, and basic imaging studies are all essential in the diagnosis of UWL. We reported a 71-year-old man suffering from profound weight loss and shuffling gait caused by pernicious anemia due to autoimmune vitamin B12 deficiency. After vitamin B12 supplement injection, there was obvious improvement in his clinical symptoms; feeding problems and loss of appetite due to tongue burning and soreness and the shuffling gait disappeared. His hemoglobin, RBC, and MCV returned to normal range, and he regained his weight.