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Clinical evidence of vitamin B-12 deficiency. Serum cobalamin levels are the initial test. Two assays exist: radioassay and the nonradioisotopic assay, chemiluminescence, which is becoming more popular because of improved automation, safety, and cost. Gigantism results when a growth hormone–secreting pituitary adenoma is present before epiphyseal fusion. In 1909, when Harvey Cushing examined the skeleton of an Irish patient who lived from ...
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Clinical course. The neurologic features are attributable to pathology in the peripheral and optic nerves, posterior and lateral columns of the spinal …
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