Papel da vitamina B12 na patogenia da mielose funicular

Canelas, Horacio M.; Carvalho, Nelson de; Rocha, Arnaldo Gama da

doi:10.1590/S0004-282X1965000400002

Resumos

Foi estudada a absorção da vitamina B12 radioativa em 29 casos de mielose funicular. O diagnóstico baseou-se na clássica sintomatologia neu- rológica e na presença de acloridria gástrica e eventuais alterações hemato-lógicas. As manifestações neurológicas foram avaliadas de modo semiquan-titativo e correlacionadas com os resultados do teste de excreção urinária da vitamina B12. Não foi verificada correlação significante da absorção da vitamina B12, quer com a sintomatologia nuerológica total, quer com as síndromes periférica e funicular dorsal. Contudo, foi encontrada significante correlação negativa entre a síndrome piramidal e a absorção da vitamina B12. Os resultados são confrontados com o papel desempenhado pela vitamina B12 na síntese das bainhas de mielina e do ácido ribonuclêico, sendo salientada a importância dêste último para a vida das células nervosas e dos longos axônios.

The absorption of labeled vitamin B12 in 29 cases of subacute combined degeneration of the spinal cord was studied. The diagnosis was based on the classical neurologic picture and on the presence of gastric achlorhydria and eventual blood or bone marrow changes. The neurologic manifestations were evaluated in a semiquantitative way and were correlated to the results of the urinary excretion test of vitamin B12. The absorption of vitamin B12 was not significantly correlated to the neurologic picture as a whole, or to the peripheral and dorsal funiculi syndromes. However, a significant negative correlation was found between the pyramidal syndrome and the absorption of vitamin B12. The results are confronted with the significance of vitamin B12 in the synthesis of myelin sheaths and ribonucleic acid, the essential role of RNA for the life of the nerve cells and the long axons being emphasized.

Vitamin B₁₂ in the pathogenesis of subacute combined degeneration of the spinal cord

Papel da vitamina B₁₂ na patogenia da mielose funicular

Horacio M. Canelas^I; Nelson de Carvalho^II; Arnaldo Gama da Rocha^I

^I(Prof. Adherbal Tolosa) and the Center of Nuclear Medicine; From the Department of Neurology of the Medical School

^II(Dr. Tede Eston) of the University of São Paulo, Brazil; From the Department of Neurology of the Medical School

ABSTRACT

The absorption of labeled vitamin B₁₂ in 29 cases of subacute combined degeneration of the spinal cord was studied. The diagnosis was based on the classical neurologic picture and on the presence of gastric achlorhydria and eventual blood or bone marrow changes. The neurologic manifestations were evaluated in a semiquantitative way and were correlated to the results of the urinary excretion test of vitamin B₁₂.

The absorption of vitamin B₁₂ was not significantly correlated to the neurologic picture as a whole, or to the peripheral and dorsal funiculi syndromes. However, a significant negative correlation was found between the pyramidal syndrome and the absorption of vitamin B₁₂.

The results are confronted with the significance of vitamin B₁₂ in the synthesis of myelin sheaths and ribonucleic acid, the essential role of RNA for the life of the nerve cells and the long axons being emphasized.

RESUMO

Foi estudada a absorção da vitamina B₁₂ radioativa em 29 casos de mielose funicular. O diagnóstico baseou-se na clássica sintomatologia neu- rológica e na presença de acloridria gástrica e eventuais alterações hemato-lógicas. As manifestações neurológicas foram avaliadas de modo semiquan-titativo e correlacionadas com os resultados do teste de excreção urinária da vitamina B₁₂.

Não foi verificada correlação significante da absorção da vitamina B₁₂, quer com a sintomatologia nuerológica total, quer com as síndromes periférica e funicular dorsal. Contudo, foi encontrada significante correlação negativa entre a síndrome piramidal e a absorção da vitamina B₁₂.

Os resultados são confrontados com o papel desempenhado pela vitamina B₁₂ na síntese das bainhas de mielina e do ácido ribonuclêico, sendo salientada a importância dêste último para a vida das células nervosas e dos longos axônios.

Full text available only in PDF format.

Texto completo disponível apenas em PDF.

1. ADAMS, J. F.; TIMBURY, G. C. - Subacute combined degeneration developing during liver therapy. Brit. med. J. i :833-834, 1959.
2. BJÖRKENHEIM, G. - Neurological changes in pernicious tapeworm anaemia. Acta med. scand., suppl. 260, 1951.
3. BOLINDER, A.; REICHARD, P. - The biosynthesis of deoxyribonucleic acid by the chick embryo. III: The influence of vitamin B₁₂ deficiency. J. biol. Chem. 234:2723-2727, 1959.
4. BOUDIN, G.; BARBIZET, J.; LABET, R. - Les neuropathies achyliques. Rev. neurol. 91:361-366, 1954.
5. CANELAS, H. M. - Quantificação clínica da sintomatologia neurológica. Rev. paul. Med. 63:178-184, 1963.
6. CANELAS, H. M.; TEIXEIRA-PINTO, J.; SHNAIDER, J. - Absorção da vitamina B₁₂ nas mieloses funiculares: estudo da absorção da radiocianocobalamina em 16 casos. Arq. Neuro-psiquiat. (S. Paulo) 19:1-10, 1961.
7. COOPERMAN, J. M.; LUHBY, A. L. TELLER, D. N.; MARLEY, J. F. - Distribution of radioactive and nonradioactive vitamin B₁₂ in the dog. J. biol. Chem. 235:191-194, 1960.
8. GEIGER, W.; FUHRMANN, W. - Zur Differentialdiagnose der funikulären Spinalerkrankung. Nervenarzt, 24: 290-298, 1953.
9. GÉLIN, G.; COIRAULT, R.; HAMED, E. B. - Vitamine B₁₂ et syndromes neuro-anémiques. Ann. Méd. 53:172-216, 1952.
10. GLASS, G. B. J. - Gastric intrinsic factor and its function in the metabolism of vitamin B₁₂ Physiol. Rev. 43:529-849, 1963.
11. GOLDSMITH, G. A.; HUNTER, F. M.; PREVATT, A. L.; UNGLAUB, W. B. - Vitamin B₁₂ and the malabsorption syndrome. Amer. J. Gastro-ent. 32:453-464, 1959.
12. INTROZZI, P. - Aspetti attuali clinici, ezio-patogenici e terapeutici dell'anemia perniciosa. Policlinico, sez. prat., 59:505-540, 1952.
13. JEWESBURY, E. C. - Subacute combined degeneration of the cord and achlorhydric peripheral neuropathies without anaemia. Lancet, ii :307-312, 1954.
14. JUHASZ, P. - Étude anatomique de 16 cas de syndrome neuro-anémique. Rev. neurol. 81: 25-43, 1949.
15. LAFON, R.; PAGES, P.; LABAUGE, R.; TEMPLE, J. P. - Le syndrome neuro-anachlorhydrique: à propos de 31 observations. Rev. neurol. 91:321-329, 1954.
16. LAUMONIER, R.; LAQUERRIÈRE, R. - Les variations de l'acide dés-oxyribonucléique (DNA) dans la dégénération hépatique. Rev. int. Hépatol. 12:633-654, 1962.
17. LOUS, P.; SCHWARTZ, M. - The absorption of vitamin B₁₂ following partial gastrectomy. Acta med. scand. 164:407-417, 1959.
18. MOLLIN, D. L.; ROSS, G. I. M. - Vitamin B₁₂ deficiency in the megaloblastic anaemia. Proc. roy. Soc. Med. 47:428-431, 1954.
19. MURPHY, W. P.; HOWARD, I. - A comparison of the effect of vitamin B₁₂ with that of liver extract in the treatment of pernicious anemia during relapse and for maintenance. New Engl. J. Med. 247:838-840, 1952.
20. NEWMAN, G. E. J.; O'BRIEN, R. P.; SPRAY, G. H.; WITTS, L. J. - Distribution of vitamin B₁₂ in rat liver cell fractions. In Henrich, H. C: Vitamin B₁₂ und intrinsic Factor. Enke, Stuttgart, 1962, p. 424-432. Cit. por Glass^,10
21. NIEWEG, H. O.; FABER, J. G.; De VRIES, J. A.; KROESE, W. F. S. - The relationship of vitamin B₁₂ and folic acid in megaloblastic anemias. J. Lab. clin. Med. 44:118-132, 1954.
22. PALVA, I. P. - Serum cholesterol level in vitamin B₁₂ deficiency of fish tapeworm carriers. Ann. Med. intern, fenn. 52:195-198, 1962.
23. PRUSOFF, W. F.; TEPLY, L. J.; KING, C. G. - The influence of pteroylglutamic acid on nucleic acid synthesis in Lactobacillus casei. J. biol. Chem. 176:1309-1317, 1948.
24. RICHMOND, J.; DAVIDSON, S. - Subacute combined degeneration of the spinal cord in non-Addisonian megaloblastic anaemia. Quart. J. Med. 27:517-531, 1958.
25. SCHILLING, R. F. - Intrinsic factor studies. II: The effect of gastric juice on the urinary excretion of radioactivity after the oral administration of radioactive vitamin B₁₂ J. Lab. clin. Med. 42:860-866, 1953.
26. SIURALA, M.; TAWAST, M. - Neurological changes in idiopathic atrophic gastritis. Ann. Med. intern, fenn. 44:13-24, 1955.
27. SPILLANE, J. D. - Nutritional disorders of the nervous system. In Elliot, K. A. V.; Page, I. V. & Quastel, J. H.: Neurochemistry. Thomas, Springfield, 1955, pp. 785-806.
28. SPINA-FRANÇA, A.; CANELAS, H. M. - Proteinograma do liquido cefalorraquidiano e do sôro sangüíneo na mielose funicular. Arq. Neuro-psiquiat. (S. Paulo) 20:183-199, 1962.
29. STRENGTH, D. R.; ALEXANDER, W. F.; WACK, J. P. - Intracellular distribution of vitamin B₁₂ Coⁱ⁰ in liver and kidney of B_J2 deficient and normal rats. Proc. Soc. exp. Biol. (N.Y.) 102:15-18, 1959.
30. SWEND-SEID, M. E.; BETHELL, F. H.; ACKERMANN, W. W.; SWANSON, A. L.; KLEIN-SCHMIDT, E. F. - The intracellular distribution of vitamin B₁₂ and folinic acid in mouse liver. J. biol. Chem. 190:791-798, 1951.
31. VICTOR, M.; LEAR, A. A. - Subacute combined degeneration of the spinal cord: current concepts of the disease process; value of serum vitamin B_]2 determination in clarifying some of the common clinical problems. Amer. J. Med. 20:896-911, 1956.
32. WANGENSTEEN, O. H. - Discussion of the paper by Goldsmith et al.¹¹ Amer. J. Gastroent. 32:464-465, 1959.
33. WINTROBE, M. M. - The search for an experimental counterpart of pernicious anemia. Arch, intern. Med. 100:862-869, 1957.
34. ZEMAN, W.; DeLAND, F. H. - Contribution to the pathogenesis of subacute combined degeneration of the spinal cord: report of two cases. Amer. J. clin. Path. 28:513-523, 1957.

Datas de Publicação

Publicação nesta coleção
15 Ago 2013
Data do Fascículo
Dez 1965

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

[1] 1. ADAMS, J. F.; TIMBURY, G. C. - Subacute combined degeneration developing during liver therapy. Brit. med. J. i :833-834, 1959.

[2] 2. BJÖRKENHEIM, G. - Neurological changes in pernicious tapeworm anaemia. Acta med. scand., suppl. 260, 1951.

[3] 3. BOLINDER, A.; REICHARD, P. - The biosynthesis of deoxyribonucleic acid by the chick embryo. III: The influence of vitamin B₁₂ deficiency. J. biol. Chem. 234:2723-2727, 1959.

[4] 4. BOUDIN, G.; BARBIZET, J.; LABET, R. - Les neuropathies achyliques. Rev. neurol. 91:361-366, 1954.

[5] 5. CANELAS, H. M. - Quantificação clínica da sintomatologia neurológica. Rev. paul. Med. 63:178-184, 1963.

[6] 6. CANELAS, H. M.; TEIXEIRA-PINTO, J.; SHNAIDER, J. - Absorção da vitamina B₁₂ nas mieloses funiculares: estudo da absorção da radiocianocobalamina em 16 casos. Arq. Neuro-psiquiat. (S. Paulo) 19:1-10, 1961.

[7] 7. COOPERMAN, J. M.; LUHBY, A. L. TELLER, D. N.; MARLEY, J. F. - Distribution of radioactive and nonradioactive vitamin B₁₂ in the dog. J. biol. Chem. 235:191-194, 1960.

[8] 8. GEIGER, W.; FUHRMANN, W. - Zur Differentialdiagnose der funikulären Spinalerkrankung. Nervenarzt, 24: 290-298, 1953.

[9] 9. GÉLIN, G.; COIRAULT, R.; HAMED, E. B. - Vitamine B₁₂ et syndromes neuro-anémiques. Ann. Méd. 53:172-216, 1952.

[10] 10. GLASS, G. B. J. - Gastric intrinsic factor and its function in the metabolism of vitamin B₁₂ Physiol. Rev. 43:529-849, 1963.

[11] 11. GOLDSMITH, G. A.; HUNTER, F. M.; PREVATT, A. L.; UNGLAUB, W. B. - Vitamin B₁₂ and the malabsorption syndrome. Amer. J. Gastro-ent. 32:453-464, 1959.

[12] 12. INTROZZI, P. - Aspetti attuali clinici, ezio-patogenici e terapeutici dell'anemia perniciosa. Policlinico, sez. prat., 59:505-540, 1952.

[13] 13. JEWESBURY, E. C. - Subacute combined degeneration of the cord and achlorhydric peripheral neuropathies without anaemia. Lancet, ii :307-312, 1954.

[14] 14. JUHASZ, P. - Étude anatomique de 16 cas de syndrome neuro-anémique. Rev. neurol. 81: 25-43, 1949.

[15] 15. LAFON, R.; PAGES, P.; LABAUGE, R.; TEMPLE, J. P. - Le syndrome neuro-anachlorhydrique: à propos de 31 observations. Rev. neurol. 91:321-329, 1954.

[16] 16. LAUMONIER, R.; LAQUERRIÈRE, R. - Les variations de l'acide dés-oxyribonucléique (DNA) dans la dégénération hépatique. Rev. int. Hépatol. 12:633-654, 1962.

[17] 17. LOUS, P.; SCHWARTZ, M. - The absorption of vitamin B₁₂ following partial gastrectomy. Acta med. scand. 164:407-417, 1959.

[18] 18. MOLLIN, D. L.; ROSS, G. I. M. - Vitamin B₁₂ deficiency in the megaloblastic anaemia. Proc. roy. Soc. Med. 47:428-431, 1954.

[19] 19. MURPHY, W. P.; HOWARD, I. - A comparison of the effect of vitamin B₁₂ with that of liver extract in the treatment of pernicious anemia during relapse and for maintenance. New Engl. J. Med. 247:838-840, 1952.

[20] 20. NEWMAN, G. E. J.; O'BRIEN, R. P.; SPRAY, G. H.; WITTS, L. J. - Distribution of vitamin B₁₂ in rat liver cell fractions. In Henrich, H. C: Vitamin B₁₂ und intrinsic Factor. Enke, Stuttgart, 1962, p. 424-432. Cit. por Glass^,10

[21] 21. NIEWEG, H. O.; FABER, J. G.; De VRIES, J. A.; KROESE, W. F. S. - The relationship of vitamin B₁₂ and folic acid in megaloblastic anemias. J. Lab. clin. Med. 44:118-132, 1954.

[22] 22. PALVA, I. P. - Serum cholesterol level in vitamin B₁₂ deficiency of fish tapeworm carriers. Ann. Med. intern, fenn. 52:195-198, 1962.

[23] 23. PRUSOFF, W. F.; TEPLY, L. J.; KING, C. G. - The influence of pteroylglutamic acid on nucleic acid synthesis in Lactobacillus casei. J. biol. Chem. 176:1309-1317, 1948.

[24] 24. RICHMOND, J.; DAVIDSON, S. - Subacute combined degeneration of the spinal cord in non-Addisonian megaloblastic anaemia. Quart. J. Med. 27:517-531, 1958.

[25] 25. SCHILLING, R. F. - Intrinsic factor studies. II: The effect of gastric juice on the urinary excretion of radioactivity after the oral administration of radioactive vitamin B₁₂ J. Lab. clin. Med. 42:860-866, 1953.

[26] 26. SIURALA, M.; TAWAST, M. - Neurological changes in idiopathic atrophic gastritis. Ann. Med. intern, fenn. 44:13-24, 1955.

[27] 27. SPILLANE, J. D. - Nutritional disorders of the nervous system. In Elliot, K. A. V.; Page, I. V. & Quastel, J. H.: Neurochemistry. Thomas, Springfield, 1955, pp. 785-806.

[28] 28. SPINA-FRANÇA, A.; CANELAS, H. M. - Proteinograma do liquido cefalorraquidiano e do sôro sangüíneo na mielose funicular. Arq. Neuro-psiquiat. (S. Paulo) 20:183-199, 1962.

[29] 29. STRENGTH, D. R.; ALEXANDER, W. F.; WACK, J. P. - Intracellular distribution of vitamin B₁₂ Coⁱ⁰ in liver and kidney of B_J2 deficient and normal rats. Proc. Soc. exp. Biol. (N.Y.) 102:15-18, 1959.

[30] 30. SWEND-SEID, M. E.; BETHELL, F. H.; ACKERMANN, W. W.; SWANSON, A. L.; KLEIN-SCHMIDT, E. F. - The intracellular distribution of vitamin B₁₂ and folinic acid in mouse liver. J. biol. Chem. 190:791-798, 1951.

[31] 31. VICTOR, M.; LEAR, A. A. - Subacute combined degeneration of the spinal cord: current concepts of the disease process; value of serum vitamin B_]2 determination in clarifying some of the common clinical problems. Amer. J. Med. 20:896-911, 1956.

[32] 32. WANGENSTEEN, O. H. - Discussion of the paper by Goldsmith et al.¹¹ Amer. J. Gastroent. 32:464-465, 1959.

[33] 33. WINTROBE, M. M. - The search for an experimental counterpart of pernicious anemia. Arch, intern. Med. 100:862-869, 1957.

[34] 34. ZEMAN, W.; DeLAND, F. H. - Contribution to the pathogenesis of subacute combined degeneration of the spinal cord: report of two cases. Amer. J. clin. Path. 28:513-523, 1957.

Brasil

Brasil

Papel da vitamina B12 na patogenia da mielose funicular

Vitamin B12 in the pathogenesis of subacute combined degeneration of the spinal cord

Resumos

Datas de Publicação