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March 1991

Abnormal Vitamin B12 Metabolism in Human Immunodeficiency Virus Infection: Association With Neurological Dysfunction

Author Affiliations

From the Departments of Neurology (Drs Kieburtz, Giang, and Schiffer) and Internal Medicine (Gastroenterology) (Dr Vakil), University of Rochester (NY) School of Medicine.

Arch Neurol. 1991;48(3):312-314. doi:10.1001/archneur.1991.00530150082023

• An increased prevalence of vitamin B12 deficiency has been reported in patients infected by the human immunodeficiency virus (HIV). We report an unexpectedly high prevalence (20%) of such abnormal vitamin B12 metabolism in a population of HIV-infected patients referred for neurological evaluation. This abnormality was associated with both peripheral neuropathy and myelopathy. A majority of those treated with cyanocobalamin had a therapeutic response. Selected neuropathological results suggest a relationship between vitamin B12 deficiency and vacuolar myelopathy. Vitamin B12 deficiency may be a frequent and treatable cause of neurological dysfunction in patients with HIV infection.

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