{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T06:39:53Z","timestamp":1789540793527,"version":"build-2803163510"},"reference-count":19,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2017,3,15]],"date-time":"2017-03-15T00:00:00Z","timestamp":1489536000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Vitamin B12 (B12) deficiency is known to be associated with various neurological manifestations. Although central manifestations such as dementia or subacute combined degeneration are the most classic, neurological manifestations also include sensory neuropathies. However, B12 deficiency is still rarely integrated as a potential cause of sensory neuronopathy. Moreover, as many medical conditions can falsely normalize serum B12 levels even in the context of a real B12 deficiency, some cases may easily remain underdiagnosed. We report the illustrating case of an anorexic patient with sensory neuronopathy and consistently normal serum B12 levels. After all classical causes of sensory neuronopathy were ruled out, her clinical and electrophysiological conditions first worsened after folate administration, but finally improved dramatically after B12 administration. B12 deficiency should be systematically part of the etiologic workup of sensory neuronopathy, especially in a high risk context such as anorexia nervosa.<\/jats:p>","DOI":"10.3390\/nu9030281","type":"journal-article","created":{"date-parts":[[2017,3,15]],"date-time":"2017-03-15T11:39:26Z","timestamp":1489577966000},"page":"281","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Sensory Neuronopathy Revealing Severe Vitamin B12 Deficiency in a Patient with Anorexia Nervosa: An Often-Forgotten Reversible Cause"],"prefix":"10.3390","volume":"9","author":[{"given":"J\u00e9r\u00f4me","family":"Franques","sequence":"first","affiliation":[{"name":"H\u00f4pital de La Casamance, 13400 Aubagne, France"},{"name":"Service de M\u00e9decine Interne, H\u00f4pital Europ\u00e9en, 13003 Marseille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurent","family":"Chiche","sequence":"additional","affiliation":[{"name":"Service de M\u00e9decine Interne, H\u00f4pital Europ\u00e9en, 13003 Marseille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0775-4625","authenticated-orcid":false,"given":"St\u00e9phane","family":"Mathis","sequence":"additional","affiliation":[{"name":"Service de Neurologie, CHU Bordeaux 33000 Bordeaux, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2017,3,15]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1503\/cmaj.1031155","article-title":"Vitamin B12 (cobalamin) deficiency in elderly patients","volume":"171","author":"Loukili","year":"2004","journal-title":"CMAJ"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"2430","DOI":"10.1161\/01.STR.0000236633.40160.ee","article-title":"Nutrition and stroke prevention","volume":"37","author":"Spence","year":"2006","journal-title":"Stroke"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"915","DOI":"10.1016\/B978-0-7020-4087-0.00060-7","article-title":"Neurologic aspects of cobalamin (B12) deficiency","volume":"120","author":"Kumar","year":"2014","journal-title":"Handb. Clin. Neurol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"991","DOI":"10.1016\/j.neurol.2013.09.004","article-title":"Neuropathies m\u00e9taboliques et carentielles: Mise au point sur le diab\u00e8te, les carences en vitamine B12 et les carences en cuivre","volume":"169","author":"Franques","year":"2013","journal-title":"Rev. Neurol. (Paris)"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1296","DOI":"10.1001\/archneur.60.9.1296","article-title":"Challenges in the identification of cobalamin-deficiency polyneuropathy","volume":"60","author":"Saperstein","year":"2003","journal-title":"Arch. Neurol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1723","DOI":"10.1093\/brain\/awp136","article-title":"The pattern and diagnostic criteria of sensory neuronopathy: A case-control study","volume":"132","author":"Jousserand","year":"2009","journal-title":"Brain"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"978","DOI":"10.1182\/blood-2004-04-1641","article-title":"Cobalamin-responsive disorders in the ambulatory care setting: Unreliability of cobalamin, methylmalonic acid, and homocysteine testing","volume":"105","author":"Solomon","year":"2005","journal-title":"Blood"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"560","DOI":"10.1136\/postgradmedj-2012-131024","article-title":"BDOSE Study Investigators. Indications for cobalamin level assessment in departments of internal medicine: A prospective practice survey","volume":"89","author":"Chiche","year":"2013","journal-title":"Postgrad. Med. J."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Ralapanawa, D.M., Jayawickreme, K.P., Ekanayake, E.M., and Jayalath, W.A. (2015). B12 deficiency with neurological manifestations in the absence of anaemia. BMC Res. Notes, 8.","DOI":"10.1186\/s13104-015-1437-9"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1016\/j.nutres.2015.10.003","article-title":"Metabolic vitamin B12 deficiency: A missed opportunity to prevent dementia and stroke","volume":"36","author":"Spence","year":"2016","journal-title":"Nutr. Res."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"2198","DOI":"10.1373\/clinchem.2009.128678","article-title":"Determinants of plasma methylmalonic acid in a large population: Implications for assessment of vitamin B12 status","volume":"55","author":"Vogiatzoglou","year":"2009","journal-title":"Clin. Chem."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"188","DOI":"10.1159\/000096149","article-title":"Tutorial in biostatistics: Analyzing associations between total plasma homocysteine and B vitamins using optimal categorization and segmented regression","volume":"27","author":"Bang","year":"2006","journal-title":"Neuroepidemiology"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"242","DOI":"10.1016\/j.neurol.2009.05.002","article-title":"Diagnostic d\u2019une carence en vitamine B12 ou le signe de l\u2019ordonnance","volume":"166","author":"Gutierrez","year":"2010","journal-title":"Rev. Neurol. (Paris)"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"162","DOI":"10.1179\/1476830515Y.0000000006","article-title":"Vitamin B12-responsive neuropathies: A case series","volume":"19","author":"Solomon","year":"2016","journal-title":"Nutr. Neurosci."},{"key":"ref_15","first-page":"146","article-title":"Use of vitamin B12 injections among elderly patients by primary care","volume":"161","author":"Austin","year":"1999","journal-title":"CMAJ"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1016\/S1474-4422(05)70096-X","article-title":"Sensory neuron diseases","volume":"4","author":"Sghirlanzoni","year":"2005","journal-title":"Lancet Neurol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"2093","DOI":"10.1007\/s00415-014-7423-7","article-title":"Testing the validity of a set of diagnostic criteria for sensory neuronopathies: A francophone collaborative study","volume":"261","author":"Antoine","year":"2014","journal-title":"J. Neurol."},{"key":"ref_18","first-page":"165","article-title":"Subacute combined degeneration in totally gastrectomized rats: An ultrastructural study","volume":"30","author":"Tredici","year":"1998","journal-title":"J. Submicrosc. Cytol. Pathol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1002\/eat.22371","article-title":"Paradoxical increase of plasma vitamin B12 and folates with disease severity in anorexia nervosa","volume":"48","author":"Corbetta","year":"2015","journal-title":"Int. J. Eat. Disord."}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/9\/3\/281\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T18:30:30Z","timestamp":1760207430000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/9\/3\/281"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,3,15]]},"references-count":19,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2017,3]]}},"alternative-id":["nu9030281"],"URL":"https:\/\/doi.org\/10.3390\/nu9030281","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,3,15]]}}}