Our case-report presents a 62 year old woman with spontaneous onset of a distinct walking disorder and pancytopenia. The diagnosis showed a sub-acute combined degeneration of the spinal cord (SACD) and a megaloblastic anemia as a result of a cobalamin deficiency. This was caused by a strict vegetarian nutrition since 18 years. Once on therapy with cobalamin substitutes the clinical and laboratory test results improved within 3 months.
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