{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T05:48:38Z","timestamp":1790747318536,"version":"4.1.0"},"reference-count":6,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"abstract":"<jats:p>A 23-year-old man presented with weakness in the lower limbs, numbness in hands and feet over past 6\u2005months. Examination revealed a combination of absent ankle jerk, extensor plantar response and reduced sensations in a glove and stocking distribution. MRI of the spinal cord was distinctive of subacute combined degeneration (SACD) of the spinal cord. Serum vitamin B<jats:sub>12<\/jats:sub>was low and anti-intrinsic factor antibodies were positive. A biopsy of the stomach revealed intense inflammatory infiltrates in lamina propria with grade III<jats:italic>Helicobacter pylori<\/jats:italic>infection. Other work-up for the cause of vitamin B<jats:sub>12<\/jats:sub>deficiency was unremarkable.<jats:italic>H pylori<\/jats:italic>infection triggers autoantibodies by a mechanism of molecular mimicry. This case report highlights<jats:italic>H pylori<\/jats:italic>as a causative agent in vitamin B<jats:sub>12<\/jats:sub>deficiency and culminating in SACD of the spinal cord.<jats:italic>H pylori<\/jats:italic>treatment reverses the underlying pathogenesis and corrects vitamin B<jats:sub>12<\/jats:sub>deficient state in selected individuals.<\/jats:p>","DOI":"10.1136\/bcr-2013-200380","type":"journal-article","created":{"date-parts":[[2013,9,30]],"date-time":"2013-09-30T10:54:39Z","timestamp":1380538479000},"page":"bcr2013200380","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":14,"title":["<i>Helicobacter pylori<\/i>associated vitamin B<sub>12<\/sub>deficiency, pernicious anaemia and subacute combined degeneration of the spinal cord"],"prefix":"10.1136","volume":"2013","author":[{"given":"H Basavana","family":"Gowdappa","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M","family":"Mahesh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K V K S N","family":"Murthy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M G","family":"Narahari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2013,9,30]]},"reference":[{"key":"2025042709235237000_2013.sep29_1.bcr2013200380.1","unstructured":"Victor AH . Megaloblastic anaemias. Longo DL . ed Harrison's principles of internal medicine. 18th edn. New York: McGraw Hill, 2012:862\u20138."},{"key":"2025042709235237000_2013.sep29_1.bcr2013200380.2","doi-asserted-by":"crossref","first-page":"437","DOI":"10.1016\/0016-5085(91)90023-E","article-title":"Helicobacter pylori infection induces antibodies cross-reacting with human gastric mucosa","volume":"2013","author":"Negrini","year":"1991","journal-title":"Gastroenterology"},{"key":"2025042709235237000_2013.sep29_1.bcr2013200380.3","first-page":"867","article-title":"Helicobacter pylori link to pernicious anaemia","volume":"2013","author":"Desai","year":"2007","journal-title":"J Assoc Physicians India"},{"key":"2025042709235237000_2013.sep29_1.bcr2013200380.4","doi-asserted-by":"crossref","first-page":"1349","DOI":"10.1001\/archinte.160.9.1349","article-title":"Helicobacter pylori\u2014it is a novel causative agent in vitamin B12 deficiency?","volume":"2013","author":"Kaptan","year":"2000","journal-title":"Arch Intern Med"},{"key":"2025042709235237000_2013.sep29_1.bcr2013200380.5","unstructured":"Patten JP . Neurological differential diagnosis. 2nd edn. New York: Springer, 2000: 234\u20135."},{"key":"2025042709235237000_2013.sep29_1.bcr2013200380.6","unstructured":"Hoffman R Benz EJ Jr Shattil SJ . Hematology: basic principles and practice. 4th edn. New York: Churchill Livingston, 2005."}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2013-200380","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,27]],"date-time":"2025-04-27T16:23:58Z","timestamp":1745771038000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2013-200380"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,9,30]]},"references-count":6,"alternative-id":["10.1136\/bcr-2013-200380"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2013-200380","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,9,30]]}}}