Table 1.
Complete Clinical Resolution Rate of Signs and Symptoms in Patients with Subacute Combined Degeneration by Clinical, Laboratory, and Radiological Findings Identified at the Time of Diagnosis
| Findings Identified at Time of Diagnosis | Complete Clinical Resolution n/N (%)* | Difference (%) | 95% Confidence Interval of Difference |
|---|---|---|---|
| Clinical characteristics and physical findings | |||
| Gender | |||
| Male | 8/36 (22.2) | 22.2 | 8.6 to 35.8 |
| Female | 0/21 (0.0) | ||
| Age | |||
| Less than 50 y | 5/18 (27.8) | 20.1 | −2.2 to 42.4 |
| More than 50 y | 3/39 (7.6) | ||
| Etiology | |||
| Vegetarian | 1/3 (33.3) | 20.3 | −34 to 74.2 |
| Other | 7/54(13) | ||
| Lhermitte sign | |||
| Absent | 0/3 (0.0) | 21.4 | 0.0 to 42.9 |
| Present | 3/14 (21.4) | ||
| Sensory level | |||
| Normal | 1/1 (100) | 91.7 | 80.6 to 103.7 |
| Abnormal | 2/24 (8.3) | ||
| Romberg sign | |||
| Absent | 2/2 (100) | 91.4 | 82.2 to 100.7 |
| Present | 3/35 (8.6) | ||
| Babinski sign | |||
| Absent | 5/15 (33.3) | 29.3 | 4.3 to 54.4 |
| Present | 1/25 (4) | ||
| Laboratory findings | |||
| Anemia | |||
| No | 2/6 (33.3) | 21.7 | −17.2 to 60.6 |
| Yes | 5/43 (11.6) | ||
| Macrocytosis | |||
| No | 1/6 (16.7) | 4.2 | −27.1 to 35.4 |
| Yes | 6/48 (12.5) | ||
| Schilling test | |||
| Normal | 0/2 (0.0) | 18.2 | 2.1 to 34.3 |
| Abnormal | 4/22 (18.2) | ||
| Vitamin B12 levels | |||
| Normal | 1/4 (25) | 11.3 | −32.2 to 54.7 |
| Decreased | 7/51 (13.7) | ||
| Antiparietal antibody | |||
| Negative | 0/7 (0.0) | 7.7 | −6.8 to 22.2 |
| Positive | 1/13 (7.7) | ||
| Anti-intrinsic factor antibody | |||
| Negative | 1/8 (12.5) | 7.5 | −23.1 to 38.1 |
| Positive | 3/15 (20) | ||
| Gastric atrophy | |||
| No | 0/3 (0.0) | 5.3 | −4.8 to 15.3 |
| Yes | 1/19 (5.3) | ||
| MRI findings | |||
| Spinal cord atrophy | |||
| Absent | 2/7 (28.6) | 28.6 | −4.9 to 62 |
| Present | 0/2(0.0) | ||
| Spinal cord abnormality | |||
| In ≤7 segments | 7/29 (24.1) | 19.9 | 2.4 to 37.5 |
| In >7 segments | 1/24 (4.2) | ||
| Spinal cord edema | |||
| Absent | 3/13 (23) | 14.5 | −26.2 to 55 |
| Present | 3/8 (37.5) | ||
| MRI contrast enhancement | |||
| Absent | 3/20 (15) | 13.6 | −23.4 to 50.5 |
| Present | 2/7 (28.6) | ||
N represents the number of patients reported to have the findings as described at the time of diagnosis and n, the number of patients who had those findings and achieved complete resolution of signs and symptoms after treatment with B12. Anemia was defined as a hemoglobin level below and macrocytosis as a mean corpuscular volume above the normal reference range of the reporting institution. The strength of association between a given finding and complete clinical resolution is indicated by the magnitude of the difference in complete resolution rates between patients with and without a given factor.