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A 66-year old man presented to our hospital due to gait disturbance. He was unable to stand or walk without assistance. Laboratory tests revealed macrocytic anemia and an extremely low serum vitamin B12 level. MRI showed high- intensity signals in the posterior and lateral column of the cervical and thoracic region of the spinal cord in T2 weighted image. Other significant laboratory results were an increased and/or positive anti-thyroid peroxidase antibody, anti-gastric parietal cell antibody and anti-intrinsic factor antibody. He was diagnosed wit