CRITICAL LIMB ISCHEMIA; A SEQUEL OF VITAMIN B-12 DEFICIENCY ANEMIA ENDING UP IN AMPUTATION: Critical Limb Ischemia; A Sequel of Vitamin B-12 Deficiency

Saeed Bin Ayaz; Atif Ahmed Khan; Sumeera Matee; Fahim Akhtar; Zaheer Ahmed Gill

Authors

Saeed Bin Ayaz Combined Military Hospital Okara/ National University of Medical Sciences (NUMS) Pakistan
Atif Ahmed Khan Armed Forces Institute of Rehabilitation Medicine/ National University of Medical Sciences (NUMS) Rawalpindi Pakistan
Sumeera Matee Armed Forces Institute of Rehabilitation Medicine/ National University of Medical Sciences (NUMS) Rawalpindi Pakistan
Fahim Akhtar Combined Military Hospital Okara/ National University of Medical Sciences (NUMS) Pakistan
Zaheer Ahmed Gill Combined Military Hospital Malir/ National University of Medical Sciences (NUMS) Pakistan

Abstract

A 35-year-old serving military soldier serving in Siachin area reported for provision of prostheses. He had a left transfemoral amputation due to critical limb ischemia (CLI). On evaluation, he had severe anemia with impaired position sense and proprioception and was unable to use the prosthesis. On further exploration, he was found to be deficient in vitamin B12 that had presumably predisposed him to develop CLI. After indoor intravenous vitamin B12 administration along with high protein and calorie diet, he improved remarkably and started using the prosthesis provided to him. He was discharged on oral mecobalamin therapy and is now on regular follow up with the internist and hematologist. Before exposure to extreme cold weather, military personnel must undergo screening for anemia in addition to other pertinent medical examination to prevent complications.

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CRITICAL LIMB ISCHEMIA; A SEQUEL OF VITAMIN B-12 DEFICIENCY ANEMIA ENDING UP IN AMPUTATION