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Reversible dementia due to vitamin B12 deficiency in a lung cancer patient: Relevance of preoperative evaluation

Published online by Cambridge University Press:  05 May 2021

Mayumi Ishida Open the ORCID record for Mayumi Ishida [Opens in a new window] ,
Ryo Taguchi ,
Hirozo Sakaguchi ,
Kumi Itami ,
Akira Yoshioka ,
Izumi Sato Open the ORCID record for Izumi Sato [Opens in a new window] ,
Nozomu Uchida Open the ORCID record for Nozomu Uchida [Opens in a new window]  and
Hideki Onishi Open the ORCID record for Hideki Onishi [Opens in a new window]
Mayumi Ishida*
Affiliation:
Department of Psycho-oncology, Saitama Medical University International Medical Center, Saitama, Japan
Ryo Taguchi
Affiliation:
Department of General Thoracic Surgery, Saitama Medical University International Medical Center, Saitama, Japan
Hirozo Sakaguchi
Affiliation:
Department of General Thoracic Surgery, Saitama Medical University International Medical Center, Saitama, Japan
Kumi Itami
Affiliation:
Department of Nursing, Saitama Medical University International Medical Center, Saitama, Japan
Akira Yoshioka
Affiliation:
Department of Clinical Oncology, Mitsubishi Kyoto Hospital, Kyoto, Japan
Izumi Sato
Affiliation:
Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University, Kyoto, Japan
Nozomu Uchida
Affiliation:
Department of General Medicine, Ogano Town Central Hospital, Saitama, Japan
Hideki Onishi
Affiliation:
Department of Psycho-oncology, Saitama Medical University International Medical Center, Saitama, Japan
*
Author for correspondence: Mayumi Ishida, Department of Psycho-oncology, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka City, Saitama350-1298, Japan. E-mail: mayumi_i@saitama-med.ac.jp
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Abstract

Objective

Cognitive dysfunction has a negative effect on cancer treatment; however, in a cancer setting, specific treatments can restore cognitive function. Such conditions are known as reversible dementia, with one of these being vitamin B12 (VB12) deficiency. However, there have been no reports of VB12 deficiency identified by preoperative evaluation in cancer patients.

Method

We studied a patient who was referred to the Department of Psycho-oncology on suspicion of cognitive decline prior to lung cancer surgery. Preoperative evaluation revealed VB12 deficiency.

Results

The patient was an 82-year-old woman diagnosed with lung cancer. She also presented with cognitive decline and, therefore, was referred to the Department of Psycho-oncology for preoperative evaluation. The patient scored 19 points on a Mini-Mental State Examination (MMSE), which is indicative of cognitive decline. As the onset of symptoms occurred several months previously and they were subacute, the possibility of reversible dementia was considered. Extensive examination revealed VB12 deficiency, and VB12 replacement therapy normalized the MMSE score to 25 points before surgery.

Significance of the results

When cognitive decline is observed in cancer patients, it is necessary to actively evaluate the serum levels of some B vitamins, including VB12.

Keywords

CancerCognitive dysfunctionDementiaMini-Mental State ExaminationVitamin B12
Type
Case Report
Information
Palliative & Supportive Care , Volume 19 , Issue 3 , June 2021 , pp. 377 - 379
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Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

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