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Vitamin B12 Deficiency due to Chlorofluorocarbon: A Case Report.

Bhaskar H, Chaudhary R - Case Rep Med (2011)

Bottom Line: However, his B12 levels were refractory to supplementation.Appropriate precautions at workplace improved patient's symptoms and were associated with significant improvement in B12 levels.Conclusion.

View Article: PubMed Central - PubMed

Affiliation: Department of Medicine, The University of Toledo, 3000 Arlington Avenue Toledo, OH 43614, USA.

ABSTRACT
Background. Vitamin B12 is vital for optimal functioning of various organ systems but more importantly the central nervous system and the hematological system. Deficiency of vitamin B12 clinically manifests as excessive daytime fatigue, memory difficulties, encephalopathy, myelopathy, peripheral neuropathy, and optic neuropathy. In occupational medicine, vitamin B12 deficiency has been reported with exposure to nitrous oxide in health care workers. However, not much is known about exposure to Freons in other industries and vitamin B12 deficiency. Aim. We are reporting a case of vitamin B12 deficiency in the setting of exposure to chlorofluorocarbon (CFC) gases. Case Report. A 55-year-old male refrigerator mechanic experienced recurrent visual symptoms, which included diplopia and blurring. A complete workup was done and was significant of vitamin B12 deficiency. However, his B12 levels were refractory to supplementation. Appropriate precautions at workplace improved patient's symptoms and were associated with significant improvement in B12 levels. Conclusion. To the best of our knowledge, this is the first reported case of vitamin B12 deficiency (that remains refractory to supplementation) in the setting of exposure to Freon gases.

No MeSH data available.


Related in: MedlinePlus

MRI image of the brain in an axial view showing the “pre-contrast T2 image”. Note the abnormal lesions (circled) in the per ventricular area suggesting white matter pathology.
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fig3: MRI image of the brain in an axial view showing the “pre-contrast T2 image”. Note the abnormal lesions (circled) in the per ventricular area suggesting white matter pathology.

Mentions: He ran a business of repairing refrigerators. His father died at the age of 84, suffered from heart disease, had brain tumor and optic nerve tumor which was removed, and was left with permanent visual disturbance. His mother also died at the age of 84 and had h/o open heart surgery, breast cancer, and diabetes mellitus. His siblings had cardiac disease and diabetes mellitus. His physical exam was normal. Upon initial presentation to his primary care physician, an imaging study of the brain was requested. An MRI of brain was obtained which showed multiple areas of T2 hyper-intensity in the subcortical white matter especially in periventricular region. Figures 1 and 2 show pre- and post-contrast FLAIR images and Figure 3 shows T2 weighted image suggesting white matter pathology. Based on the neuroimaging, a demyelinating process was hypothesized.


Vitamin B12 Deficiency due to Chlorofluorocarbon: A Case Report.

Bhaskar H, Chaudhary R - Case Rep Med (2011)

MRI image of the brain in an axial view showing the “pre-contrast T2 image”. Note the abnormal lesions (circled) in the per ventricular area suggesting white matter pathology.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3065218&req=5

fig3: MRI image of the brain in an axial view showing the “pre-contrast T2 image”. Note the abnormal lesions (circled) in the per ventricular area suggesting white matter pathology.
Mentions: He ran a business of repairing refrigerators. His father died at the age of 84, suffered from heart disease, had brain tumor and optic nerve tumor which was removed, and was left with permanent visual disturbance. His mother also died at the age of 84 and had h/o open heart surgery, breast cancer, and diabetes mellitus. His siblings had cardiac disease and diabetes mellitus. His physical exam was normal. Upon initial presentation to his primary care physician, an imaging study of the brain was requested. An MRI of brain was obtained which showed multiple areas of T2 hyper-intensity in the subcortical white matter especially in periventricular region. Figures 1 and 2 show pre- and post-contrast FLAIR images and Figure 3 shows T2 weighted image suggesting white matter pathology. Based on the neuroimaging, a demyelinating process was hypothesized.

Bottom Line: However, his B12 levels were refractory to supplementation.Appropriate precautions at workplace improved patient's symptoms and were associated with significant improvement in B12 levels.Conclusion.

View Article: PubMed Central - PubMed

Affiliation: Department of Medicine, The University of Toledo, 3000 Arlington Avenue Toledo, OH 43614, USA.

ABSTRACT
Background. Vitamin B12 is vital for optimal functioning of various organ systems but more importantly the central nervous system and the hematological system. Deficiency of vitamin B12 clinically manifests as excessive daytime fatigue, memory difficulties, encephalopathy, myelopathy, peripheral neuropathy, and optic neuropathy. In occupational medicine, vitamin B12 deficiency has been reported with exposure to nitrous oxide in health care workers. However, not much is known about exposure to Freons in other industries and vitamin B12 deficiency. Aim. We are reporting a case of vitamin B12 deficiency in the setting of exposure to chlorofluorocarbon (CFC) gases. Case Report. A 55-year-old male refrigerator mechanic experienced recurrent visual symptoms, which included diplopia and blurring. A complete workup was done and was significant of vitamin B12 deficiency. However, his B12 levels were refractory to supplementation. Appropriate precautions at workplace improved patient's symptoms and were associated with significant improvement in B12 levels. Conclusion. To the best of our knowledge, this is the first reported case of vitamin B12 deficiency (that remains refractory to supplementation) in the setting of exposure to Freon gases.

No MeSH data available.


Related in: MedlinePlus