TITLE:
Biermer Disease in an Unusual Neurological Presentation without Anemia: A Case Report
AUTHORS:
Nsenga Djapa Guy Roger, Fogang Fogoum Yannick, Ndjitoyap Ndam Antonin Wilson, Kowo Pierre Mathurin, Ankouane Andoulo Firmin, Choukem Simon Pierre
KEYWORDS:
Biermer Disease, Pernicious Anemia, Autoimmune Disease, Atrophic Gastritis, Vitamin B12 Deficiency, Cameroon
JOURNAL NAME:
Open Journal of Gastroenterology,
Vol.12 No.5,
May
31,
2022
ABSTRACT: Background: Biermer disease is a megaloblastic
disease caused by vitamin B12 deficiency. It is a rare clinical entity especially
in subsahara Africa. Case presentation: We report the case of a 45 years
old female patient who consulted for a one month history of generalised muscle cramps,
weakness and numbness of all four limbs. Physical examination was relevant for a
poor gait, poor coordination of both upper and lower limbs, a positive Romberg sign,
normal muscle tone in all four limbs, reduced pallesthesia and deep tendon reflexes,
abolished plantar reflexes. Paraclinical investigations revealed macrocytosis without
anemia, a low cyanocobalamin (vitamin B12) level with a normal folic
acid level, an atrophic corporeofundic mucosa which upon pathological analysis revealed a chronic atrophic gastritis with no Helicobacter pylori infection. Anti-intrinsic factor
antibodies were positive while anti parietal cells antibodies were negative. The
diagnosis of Biermer disease was considered and the patient did well on vitamin
B12 supplementation. Conclusion: Though a rare disease, Biermer
disease should be considered in a patient who consults for polyneuropathy even in
the absence of anemia.