Subacute combined degeneration: Adult monozygous twins

Abstract

Scientific Background: Subacute combined degeneration (SCD) is characterized with hematologic, gastrointestinal and neuropsychiatric symptoms due to B12 deficiency. Pernicious anemia is one of the main reasons of this syndrome. The disease is supposed to be autoimmune with high levels of intrinsic factor antibodies. Objective: In this paper, SCD syndrome in 38 year-old monozygous twins with gait disorder and chronic atrophic gastritis is reviewed. Findings: In 38 year-old male monozygous twins with gait disturbance, asymmetric spastic quadriparesis (right3/5, left 4/5), sensory (vibratory and position) diturbance were detected on neurological examination. Laboratory analysisrevealed multiple polymorphic leukocytes, chronic atrophic gastritis, antiparietal antibodies and bilateral abnormal SEP. After treatment, B12 level returned to normal whereas some symptoms persisted. Conclusion: Our case is interesting since it is the first SCD case due to pernicious anemia in adult monozygous twins.