Reversible hyperpigmentation in Vitamin B12 deficiency: an addisonian mimic in clinical practice
Vitamin B12 deficiency may present with gastrointestinal, haematologic, dermatologic and neuropsychiatric signs and symptoms. Skin hyperpigmentation is a dermatologic manifestation which may mimic the features seen in Addison´s disease. We report a case of a 33-year-old non-vegan man who presented w...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
PAMJ
2020-11-01
|
| Series: | PAMJ Clinical Medicine |
| Subjects: | |
| Online Access: |
https://www.clinical-medicine.panafrican-med-journal.com/content/article/4/109/pdf/109.pdf
|
| _version_ | 1818864743426818048 |
|---|---|
| author | Rosemary Abena Kuenyefu Awindaogo Ivy Ekem Nana Agyeiwah Awuku Soziema Salia Martin Agyei Yvonne Ayerki Nartey Yaw Asante Awuku |
| author_facet | Rosemary Abena Kuenyefu Awindaogo Ivy Ekem Nana Agyeiwah Awuku Soziema Salia Martin Agyei Yvonne Ayerki Nartey Yaw Asante Awuku |
| author_sort | Rosemary Abena Kuenyefu Awindaogo |
| collection | DOAJ |
| description | Vitamin B12 deficiency may present with gastrointestinal, haematologic, dermatologic and neuropsychiatric signs and symptoms. Skin hyperpigmentation is a dermatologic manifestation which may mimic the features seen in Addison´s disease. We report a case of a 33-year-old non-vegan man who presented with progressive darkening of his palms, knuckles and feet which was associated with anaemia. Low serum vitamin B12 levels coupled with characteristic morphology of peripheral blood smear and bone marrow aspirate were identified. An extensive work up to establish the cause of Vitamin B12 deficiency revealed Helicobacter pyloriassociated gastritis as the likely aetiology. The patient had significant reversibility of hyperpigmentation and normalisation of the haematological indices following parenteral vitamin B12 supplementation. This case highlights the need for a high index of suspicion when clinicians are faced with a case of hyperpigmentation, so that the appropriate treatment can be promptly instituted and the late irreversible complications of vitamin B12 deficiency prevented. |
| first_indexed | 2024-12-19T10:36:30Z |
| format | Article |
| id | doaj.art-d1e107f23d0444e593aca520cff84b45 |
| institution | Directory Open Access Journal |
| issn | 2707-2797 2707-2797 |
| language | English |
| last_indexed | 2024-12-19T10:36:30Z |
| publishDate | 2020-11-01 |
| publisher | PAMJ |
| record_format | Article |
| series | PAMJ Clinical Medicine |
| spelling | doaj.art-d1e107f23d0444e593aca520cff84b452022-12-21T20:25:35ZengPAMJPAMJ Clinical Medicine2707-27972707-27972020-11-01410910.11604/pamj-cm.2020.4.109.2664126641Reversible hyperpigmentation in Vitamin B12 deficiency: an addisonian mimic in clinical practiceRosemary Abena Kuenyefu Awindaogo0Ivy Ekem1Nana Agyeiwah Awuku2Soziema Salia3Martin Agyei4Yvonne Ayerki Nartey5Yaw Asante Awuku6 Department of Internal Medicine, Cape Coast Teaching Hospital, Cape Coast, Ghana Department of Haematology, School of Medical Sciences, University of Cape Coast, Cape Coast, Ghana Department of Haematology, Cape Coast Teaching Hospital, Cape Coast, Ghana Department of Internal Medicine, Cape Coast Teaching Hospital, Cape Coast, Ghana Department of Medicine, School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana Department of Internal Medicine, Cape Coast Teaching Hospital, Cape Coast, Ghana Department of Internal Medicine, Cape Coast Teaching Hospital, Cape Coast, Ghana Vitamin B12 deficiency may present with gastrointestinal, haematologic, dermatologic and neuropsychiatric signs and symptoms. Skin hyperpigmentation is a dermatologic manifestation which may mimic the features seen in Addison´s disease. We report a case of a 33-year-old non-vegan man who presented with progressive darkening of his palms, knuckles and feet which was associated with anaemia. Low serum vitamin B12 levels coupled with characteristic morphology of peripheral blood smear and bone marrow aspirate were identified. An extensive work up to establish the cause of Vitamin B12 deficiency revealed Helicobacter pyloriassociated gastritis as the likely aetiology. The patient had significant reversibility of hyperpigmentation and normalisation of the haematological indices following parenteral vitamin B12 supplementation. This case highlights the need for a high index of suspicion when clinicians are faced with a case of hyperpigmentation, so that the appropriate treatment can be promptly instituted and the late irreversible complications of vitamin B12 deficiency prevented. https://www.clinical-medicine.panafrican-med-journal.com/content/article/4/109/pdf/109.pdf hyperpigmentationvitamin b12 deficiencyhelicobacter pylorigastritis |
| spellingShingle | Rosemary Abena Kuenyefu Awindaogo Ivy Ekem Nana Agyeiwah Awuku Soziema Salia Martin Agyei Yvonne Ayerki Nartey Yaw Asante Awuku Reversible hyperpigmentation in Vitamin B12 deficiency: an addisonian mimic in clinical practice PAMJ Clinical Medicine hyperpigmentation vitamin b12 deficiency helicobacter pylori gastritis |
| title | Reversible hyperpigmentation in Vitamin B12 deficiency: an addisonian mimic in clinical practice |
| title_full | Reversible hyperpigmentation in Vitamin B12 deficiency: an addisonian mimic in clinical practice |
| title_fullStr | Reversible hyperpigmentation in Vitamin B12 deficiency: an addisonian mimic in clinical practice |
| title_full_unstemmed | Reversible hyperpigmentation in Vitamin B12 deficiency: an addisonian mimic in clinical practice |
| title_short | Reversible hyperpigmentation in Vitamin B12 deficiency: an addisonian mimic in clinical practice |
| title_sort | reversible hyperpigmentation in vitamin b12 deficiency an addisonian mimic in clinical practice |
| topic | hyperpigmentation vitamin b12 deficiency helicobacter pylori gastritis |
| url |
https://www.clinical-medicine.panafrican-med-journal.com/content/article/4/109/pdf/109.pdf
|
| work_keys_str_mv | AT rosemaryabenakuenyefuawindaogo reversiblehyperpigmentationinvitaminb12deficiencyanaddisonianmimicinclinicalpractice AT ivyekem reversiblehyperpigmentationinvitaminb12deficiencyanaddisonianmimicinclinicalpractice AT nanaagyeiwahawuku reversiblehyperpigmentationinvitaminb12deficiencyanaddisonianmimicinclinicalpractice AT soziemasalia reversiblehyperpigmentationinvitaminb12deficiencyanaddisonianmimicinclinicalpractice AT martinagyei reversiblehyperpigmentationinvitaminb12deficiencyanaddisonianmimicinclinicalpractice AT yvonneayerkinartey reversiblehyperpigmentationinvitaminb12deficiencyanaddisonianmimicinclinicalpractice AT yawasanteawuku reversiblehyperpigmentationinvitaminb12deficiencyanaddisonianmimicinclinicalpractice |