A 50-year-old man presents with a “staggering” gait and “lightning pain” in his hands and legs. His past medical history is significant for an aortic aneurysm and aortic insufficiency. Neurologic...

A 50-year-old man presents with a “staggering” gait and “lightning pain” in his hands and legs. His past medical history is significant for an aortic aneurysm and aortic insufficiency. Neurologic examination reveals impaired senses of vibration, as well as touch and pain in the lower extremities. The patient subsequently dies of pneumonia. Autopsy discloses obliterative endarteritis of meningeal blood vessels and atrophy of the posterior columns of the spinal cord. What is the appropriate diagnosis?

(A) Amyotrophic lateral sclerosis

(B) Friedreich ataxia

(C) Huntington disease

(D) Tabes dorsalis

(E) Vitamin B12 deficiency (subacute combined degeneration)