2008 - Communication Across the Curriculum (CAC)

C a s e S t u d y
associated with dementia and other possible related diseases.
He tested negative for Alzheimer’s, cancer, stroke, tumor and
infection. His spinal fluid was normal, brain imaging was normal,
thyroid levels were normal, as was his blood work, except for
having slightly enlarged RBC’s (Bernstein).
After a psychiatric evaluation, Pop’s diagnosis was altered to
“toxic/organic dementia disease without significant depression.”
However, there was no trace of any toxins in his blood or
exposure to harmful substances (Bernstein).
A neurologist concluded that Pop had “rapidly progressive
dementia of unknown origin, with severe changes in coordination,
emotional lability, and signs of frontal lobe dysfunction involving
higher centers of reasoning and memory”. The diagnoses
were inconclusive from the test results and Pop was rapidly
degenerating. Within two days of hospitalization he was unable
to stand, and had lost all bowel control (Bernstein).
Final Diagnosis:
Pop’s doctor was not satisfied diagnosing him with
dementia. Even though his symptoms seemed to be accurate
for the diagnosis, the rapidness of the onset and progression
of his symptoms were not congruent. Nor were the results
of the laboratory tests. Finally, upon reviewing Pop’s history
his doctor ordered one more blood draw. After 38 years of a
vegan, diet Pop was deficient in vitamin B12 (Bernstein). A B12
reading above 150pg/ml is considered normal, 80-150pg/ml is
considered low and less than 80pg/ml is considered deficient
(McDougall 3). Pop’s deficiency was so severe his B12 levels
were undetectable, which explains why during the initial tests
the deficiency was not detected (Bernstein).
Pop’s doctor diagnosed him with a condition that results from
vitamin B12 deficiency called pernicious anemia (Bernstein).
However, pernicious anemia develops as a result of a lack of
gastric intrinsic factor production. Intrinsic factor is the enzyme
responsible for the absorption of vitamin B12. Pop’s condition
was not due to a lack of absorption of B12, it was a complete
depletion of this essential vitamin (Koda-Kimball 86-10).
Vitamin B12 is involved as a coenzyme in metabolism of all
cells in the body; however, the effects of deficits are first seen
in the blood, (when erythrocytes stop dividing and become
enlarged) and then in the nervous system (Marieb 951,
McDougall 1). B12 is also known as Cobalamin (Koda-Kimble
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