Absorption of Radioactive Vitamin B12in Nonanemic Patients with Combined-System Disease

Abstract

BEFORE the advent of liver or vitamin B₁₂ treatment of pernicious anemia, approximately 80 per cent of patients who died of this disease had neurologic signs resulting from demyelinization of the posterior and lateral columns of the spinal cord.¹ This neurologic disorder has been variously termed combined-system disease, posterolateral sclerosis, subacute combined degeneration of the spinal cord and funicular degeneration. Its pathology, clinical course and response to treatment are well kno-n.^{2 3 4 5 6 7} In vitamin B₁₂ deficiency, anemia usually precedes the development of neurologic signs and symptoms, but occasionally this sequence is reversed and extensive neurologic damage may occur in . . .