Reversible Cognitive Impairment Associated With Severe Vitamin B12 Deficiency Despite Normal Hemoglobin : 대한자가면역성위염연구회

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증례 및 화보

2026-09-09

Maeda K, Hori T, Miyachi J, Sato K, Shimizu T.

J Gen Fam Med. 2026 Sep 6;27(5):e70172. doi: 10.1002/jgf2.70172.

1. Background

2.

Vitamin B12 deficiency is a potentially treatable cause of neurological and neuropsychiatric manifestations, including cognitive impairment, and may occur in the absence of anemia1. We report an older patient with severe vitamin B12 deficiency and progressive cognitive and functional decline who showed substantial improvement after vitamin B12 replacement. Although a direct causal relationship could not be established, this case highlights the importance of measuring serum vitamin B12 in patients with cognitive decline, even when the hemoglobin level is normal. Although the underlying cause of vitamin B12 deficiency could not be definitively established, autoimmune gastritis remained a possible etiology because intrinsic factor antibodies were positive.

Keywords: normal hemoglobin; reversible cognitive impairment; vitamin B12 deficiency

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Case Report: A rare case of multiple gastrointestinal autoimmune disorders mimicking autoimmune polyglandular syndrome type 3B

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AsiaReversible Cognitive Impairment Associated With Severe Vitamin B12 Deficiency Despite Normal Hemoglobin