A Case of Pseudothrombotic Microangiopathy Presenting with Cognitive Dysfunction

Year 2024, , 78 - 82, 30.04.2024

İldeniz Bilgiçler Suleyman Emre Kocyıgıt

https://doi.org/10.47141/geriatrik.1402994

Abstract

Cognitive dysfunction is one of the leading reasons for admission to the geriatric unit in older adults. These patients should be evaluated primarily in the presence of dementia within the framework of comprehensive geriatric assessment. Many clinical presentations can mimic dementia in elderly individuals. In this respect, the differential diagnosis of cognitive dysfunction should be made carefully. One of the causes of reversible dementia in the elderly may develop secondary to vitamin B12 deficiency. In geriatric practice, vitamin B12 deficiency seen mostly mild to moderate and no other laboratory changes are observed. A thrombotic microangiopathy (TMA)-like condition secondary to vitamin B12 deficiency is very rare in older adults, and it is not common to present with a severe laboratory changes and accompanying cognitive dysfunction. A case report was presented about pseudo-TMA secondary to vitamin b12 deficiency and concurrent cognitive dysfunction that affects daily living activities and in addition, cognitive improvement after vitamin B12 supplementation was observed.

Keywords

Vitamin B12 Deficiency, Thrombotic Microangiopathies, Cognitive Dysfunction

Kognitif Disfonksiyon ile Başvuran Bir Psödo Trombotik Mikroanjiopati Vakası

Abstract

Yaşlılarda kognitif disfonksiyon geriatri birimine önde gelen başvuru sebeplerindendir. Bu tür hastalar ayrıntılı geriatrik değerlendirme çerçevesinde ön planda demans açısından değerlendirilmelidir. Yaşlı bireylerde pek çok klinik tablo demansı taklit edebilmektedir. Bu açıdan kognitif disfonksiyonun ayırıcı tanısı dikkatli bir şekilde yapılmalıdır. Yaşlılarda geriye döndürülebilir demans sebeplerinden biri de vitamin B12 eksikliğine sekonder gelişebilmektedir. Geriatri pratiğinde çoğunlukla vitamin B12 eksikliği hafif-orta düzeyde olup, başka bir laboratuvar değişiklik gözlenmemektedir. Vitamin B12 eksikliğine ikincil trombotik mikroanjiopati (TMA) benzeri tablo yaşlı bireylerde oldukça nadir olup, ön planda gürültülü bir laboratuvar tablo ve bununla beraber kognitif disfonksiyon ile başvurması da sık görülmemektedir. Vitamin B12 eksikliğine sekonder psödo TMA tablosu ve günlük yaşam aktivitelerini etkileyecek düzeyde kognitif disfonksiyon ile başvuran; vitamin B12 replasmanı sonrası kognitif iyileşme gösteren bir olgu sunumu yapılmıştır.

Keywords

Vitamin B12 Eksikliği, Trombotik Mikroanjiopatiler, Kognitif Disfonksiyon

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