Subacute Combined Degeneration of the Spinal Cord
Secondary to Pernicious Anaemia
Introduction
There are two major problems in diagnosing Pernicious Anaemia. Firstly the symptoms are insidious–they don’t suddenly appear but gradually emerge, sometimes over a very long time which means it can, and often does, take many years before the symptoms are experienced by the patient to the extent that medical advice is sought. Secondly the symptoms of Pernicious Anaemia are many and often vague and not only do they manifest themselves in different degrees of severity but also physicians often associate them as indicators of the patient having a wide variety of other diseases and medical conditions. These two problems with the symptoms of Pernicious Anaemia can, either individually or together, lead to the patient receiving a late diagnosis –and this can and does lead to damage to the patient’s nervous system.
SACDC
A patient with Pernicious Anaemia who has yet to be diagnosed and treated will be deficient in Vitamin B12.
Vitamin B12 is not only needed to produce healthy red blood cells that will transport oxygen around the patient’s body, but it is also needed, along with various other substances, to maintain a healthy nervous system. Left untreated the Vitamin B12 deficiency leads to damage to the insulation that surrounds nerves. This ‘coating’ is called the Myelin Sheath and its purpose is to speed up nerve impulses. Severe B12 deficiency over a period of time leads to the Myelin Sheath wasting away – Demyelination. When the Myelin sheath withers away due to lack of Vitamin B12 then the diagnosis is Sub-Acute Combined Degeneration of the Cord Secondary to Pernicious Anaemia (SACDC). The transmission of signals along nerves is compromised or entirely lost and left untreated the nerve will ultimately become useless.