甲状腺功能减退、内因子抗体阳性合并脊髓亚急性联合变性1例病例报告及文献复习

Hypothyroidism, Positive Intrinsic Factor Antibodies, and Subacute Combined Degeneration of the Spinal Cord: A Case Report and Literature Review

摘要: 目的：报道1例甲状腺功能减退合并脊髓亚急性联合变性病例。方法：回顾性讨论收治的1例甲状腺功能减退合并脊髓亚急性联合变性的临床资料并进行分析。结果：患者为老年女性，临床主要表现为双下肢乏力，血清内因子抗体为阳性，血清维生素B12、甲状腺激素检测均低于正常下限，给予补充维生素B12、补充甲状腺素及其他对症支持治疗一段时间后，各项化验指标均趋于正常，症状明显好转。结论：甲状腺功能减退症、内因子抗体阳性均可引起维生素B12缺乏导致脊髓亚急性联合变性，及时补充维生素B12是本病最有效的治疗方法。

Abstract: Objective: To report a case of hypothyroidism combined with subacute spinal cord degeneration. Method: A retrospective discussion was conducted on the clinical data of a case of hypothyroidism combined with subacute spinal cord degeneration treated in our hospital, and the data were ana-lyzed. Results: The patient was an elderly woman with clinical manifestations of weakness in both lower limbs, positive serum factor antibodies, and serum vitamin B12 and thyroid hormone tests all below the lower limit of normal. After receiving vitamin B12 supplementation, thyroid hormone supplementation, and other symptomatic supportive treatments for a period of time, all laboratory indicators tended to be normal and symptoms improved significantly. Conclusion: Hypothyroidism and positive intrinsic factor antibodies can both cause vitamin B12 deficiency leading to subacute combined degeneration of the spinal cord. Timely supplementation of vitamin B12 is the most ef-fective treatment method for this disease.