{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T14:57:48Z","timestamp":1787065068673,"version":"build-2736575974"},"reference-count":12,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2022,10,4]],"date-time":"2022-10-04T00:00:00Z","timestamp":1664841600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,10,4]],"date-time":"2022-10-04T00:00:00Z","timestamp":1664841600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Shenzhen second people's hospital clinical research project","award":["20203357027"],"award-info":[{"award-number":["20203357027"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Neurol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Subacute combined degeneration (SCD) is a demyelinating disease characterized by vitamin B12 deficiency related segmental degeneration of the dorsal or lateral columns of the spinal cord. However, few cases have been reported as a comorbidity of SCD and neuromyelitis optica spectrum disease (NMOSD).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>Herein, we describe a female patient (61-year-old) who had sensory deficits, paresthesia, and weakness of the distal extremities for over 2\u2009months. She then received an initial diagnosis of SCD with typical inverted \u201cV-sigh\u201d hyperintensities over the posterior aspect of the spinal cord in magnetic resonance imaging (MRI - T2-weighted imaging), as well as megaloblastic anaemia in blood examinations. From the past history, there was no evidence of a dietary deficiency or gastric abnormalities. However, traditional treatment with vitamin B12 supplementation was ineffective. Hence, a demyelinating antibody examination showed that she had antibodies targeting aquaporin 4 (AQP4) in both the cerebrospinal fluid and serum, leading to the diagnosis of NMOSD. Her clinical symptoms were obviously improved after treatment with intravenous glucocorticoids.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>People who have nutritional deficiency or altered gastrointestinal function are more likely to develop SCD. This case raises the awareness that the poor therapeutic effects of simple vitamin B12 supplementation could be explained by immunoreactions against AQP4. A better recognition will be of great importance for the correct diagnosis of the comorbidity, as well as for essential treatment and even a better prognosis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12883-022-02870-4","type":"journal-article","created":{"date-parts":[[2022,10,4]],"date-time":"2022-10-04T05:02:34Z","timestamp":1664859754000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Neuromyelitis optica spectrum disease coexisting with subacute combined degeneration: a case report"],"prefix":"10.1186","volume":"22","author":[{"given":"Yixuan","family":"Zeng","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Runtao","family":"Bai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanxia","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8085-0907","authenticated-orcid":false,"given":"Lijie","family":"Ren","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,10,4]]},"reference":[{"issue":"10","key":"2870_CR1","doi-asserted-by":"publisher","first-page":"1819","DOI":"10.1007\/s10072-013-1301-4","volume":"34","author":"N Ishii","year":"2013","unstructured":"Ishii N, Mochizuki H, Takahashi T, Shiomi K, Nakazato M. A case of simultaneous neuromyelitis optica spectrum disorder and subacute combined degeneration. Neurol Sci. 2013;34(10):1819\u201321. https:\/\/doi.org\/10.1007\/s10072-013-1301-4.","journal-title":"Neurol Sci"},{"key":"2870_CR2","doi-asserted-by":"publisher","first-page":"626174","DOI":"10.3389\/fneur.2021.626174","volume":"12","author":"H Gao","year":"2021","unstructured":"Gao H, et al. Clinical and MRI differences between patients with subacute combined degeneration of the spinal cord related vs. unrelated to recreational nitrous oxide use: a retrospective study. Front Neurol. 2021;12:626174.","journal-title":"Front Neurol"},{"issue":"2","key":"2870_CR3","doi-asserted-by":"publisher","first-page":"177","DOI":"10.1212\/WNL.0000000000001729","volume":"85","author":"DM Wingerchuk","year":"2015","unstructured":"Wingerchuk DM, et al. International consensus diagnostic criteria for neuromyelitis optica spectrum disorders. Neurology. 2015;85(2):177\u201389.","journal-title":"Neurology"},{"issue":"12","key":"2870_CR4","doi-asserted-by":"publisher","first-page":"2743","DOI":"10.1007\/s00415-012-6677-1","volume":"259","author":"S Jarius","year":"2012","unstructured":"Jarius S, et al. Low vitamin B12 levels and gastric parietal cell antibodies in patients with aquaporin-4 antibody-positive neuromyelitis optica spectrum disorders. J Neurol. 2012;259(12):2743\u20135.","journal-title":"J Neurol"},{"issue":"1","key":"2870_CR5","doi-asserted-by":"publisher","first-page":"162","DOI":"10.1186\/s12883-014-0162-7","volume":"14","author":"B Zhang","year":"2014","unstructured":"Zhang B, et al. Neuromyelitis optica spectrum disorders without and with autoimmune diseases. BMC Neurol. 2014;14(1):162.","journal-title":"BMC Neurol"},{"key":"2870_CR6","doi-asserted-by":"publisher","first-page":"350","DOI":"10.1016\/j.msard.2018.11.008","volume":"27","author":"S Shahmohammadi","year":"2019","unstructured":"Shahmohammadi S, et al. Autoimmune diseases associated with Neuromyelitis Optica Spectrum disorders: a literature review. Mult Scler Relat Disord. 2019;27:350\u201363.","journal-title":"Mult Scler Relat Disord"},{"issue":"10","key":"2870_CR7","doi-asserted-by":"publisher","first-page":"1733","DOI":"10.3390\/ijms17101733","volume":"17","author":"H Skovierova","year":"2016","unstructured":"Skovierova H, et al. The molecular and cellular effect of homocysteine metabolism imbalance on human health. Int J Mol Sci. 2016;17(10):1733.","journal-title":"Int J Mol Sci"},{"key":"2870_CR8","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1016\/j.jocn.2020.08.005","volume":"80","author":"Z Bi","year":"2020","unstructured":"Bi Z, et al. Correlation between anemia and clinical severity in subacute combined degeneration patients. J Clin Neurosci. 2020;80:11\u20135.","journal-title":"J Clin Neurosci"},{"key":"2870_CR9","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1080\/15563650.2022.2046772","volume":"60","author":"C Temple","year":"2022","unstructured":"Temple C, Zane Horowitz B. Nitrous oxide abuse induced subacute combined degeneration despite patient initiated B12 supplementation. Clin Toxicol (Phila). 2022;60:1\u20134.","journal-title":"Clin Toxicol (Phila)"},{"key":"2870_CR10","doi-asserted-by":"publisher","first-page":"667651","DOI":"10.3389\/fneur.2021.667651","volume":"12","author":"J Zhang","year":"2021","unstructured":"Zhang J, et al. Serum homocysteine level is a predictor of relapse and prognosis in patients with first-attack Neuromyelitis Optica Spectrum disorders. Front Neurol. 2021;12:667651.","journal-title":"Front Neurol"},{"issue":"3","key":"2870_CR11","doi-asserted-by":"publisher","first-page":"250","DOI":"10.1097\/BOR.0000000000000603","volume":"31","author":"AR Romeo","year":"2019","unstructured":"Romeo AR, Segal BM. Treatment of neuromyelitis optica spectrum disorders. Curr Opin Rheumatol. 2019;31(3):250\u20135.","journal-title":"Curr Opin Rheumatol"},{"issue":"5","key":"2870_CR12","doi-asserted-by":"publisher","first-page":"317","DOI":"10.5603\/PJNNS.a2019.0049","volume":"53","author":"K Selmaj","year":"2019","unstructured":"Selmaj K, Selmaj I. Novel emerging treatments for NMOSD. 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