Vitamin B-12 deficiency: Difference between revisions

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Folic acid levels may not help.<ref name="pmid18414954">{{cite journal| author=Ashraf MJ, Cook JR, Rothberg MB| title=Clinical utility of folic acid testing for patients with anemia or dementia. | journal=J Gen Intern Med | year= 2008 | volume= 23 | issue= 6 | pages= 824-6 | pmid=18414954 | doi=10.1007/s11606-008-0615-z | pmc=PMC2517884 | url= }} </ref>
Folic acid levels may not help.<ref name="pmid18414954">{{cite journal| author=Ashraf MJ, Cook JR, Rothberg MB| title=Clinical utility of folic acid testing for patients with anemia or dementia. | journal=J Gen Intern Med | year= 2008 | volume= 23 | issue= 6 | pages= 824-6 | pmid=18414954 | doi=10.1007/s11606-008-0615-z | pmc=PMC2517884 | url= }} </ref>
B12 levels may have imperfect sensitivity<ref name="pmid7603218">{{cite journal| author=Naurath HJ, Joosten E, Riezler R, Stabler SP, Allen RH, Lindenbaum J| title=Effects of vitamin B12, folate, and vitamin B6 supplements in elderly people with normal serum vitamin concentrations. | journal=Lancet | year= 1995 | volume= 346 | issue= 8967 | pages= 85-9 | pmid=7603218 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7603218  }} </ref> and low positive predictive value.<ref name="pmid7977446">{{cite journal| author=Matchar DB, McCrory DC, Millington DS, Feussner JR| title=Performance of the serum cobalamin assay for diagnosis of cobalamin deficiency. | journal=Am J Med Sci | year= 1994 | volume= 308 | issue= 5 | pages= 276-83 | pmid=7977446 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7977446  }} </ref>


Diagnosis may be especially difficult in alcoholics.<ref name="pmid3747828">{{cite journal| author=Savage D, Lindenbaum J| title=Anemia in alcoholics. | journal=Medicine (Baltimore) | year= 1986 | volume= 65 | issue= 5 | pages= 322-38 | pmid=3747828 | doi= | pmc= | url= }} </ref>
Diagnosis may be especially difficult in alcoholics.<ref name="pmid3747828">{{cite journal| author=Savage D, Lindenbaum J| title=Anemia in alcoholics. | journal=Medicine (Baltimore) | year= 1986 | volume= 65 | issue= 5 | pages= 322-38 | pmid=3747828 | doi= | pmc= | url= }} </ref>

Revision as of 08:49, 3 July 2012

In medicine, vitamin B-12 deficiency, is a "nutritional condition produced by a deficiency of Vitamin B-12 in the diet, characterized by megaloblastic anemia. Since vitamin B 12 is not present in plants, humans have obtained their supply from animal products, from multivitamin supplements in the form of pills, and as additives to food preparations. A wide variety of neuropsychiatric abnormalities is also seen in vitamin B 12 deficiency and appears to be due to an undefined defect involving myelin synthesis."[1]

Manifestations include pernicious anemia and subacute combined degeneration.

Vitamin B-12 deficiency may be combined with iron deficiency anemia.[2]

Diagnosis

Vitamin B-12 deficiency may be an explanation for macrocytosis[3]

However, the MCV is not completely accurate.[4][5]

Folic acid levels may not help.[6]

B12 levels may have imperfect sensitivity[7] and low positive predictive value.[8]

Diagnosis may be especially difficult in alcoholics.[9]

Treatment

Oral therapy may be effective.[10]

References

  1. ↑ Anonymous (2024), Vitamin B-12 deficiency (English). Medical Subject Headings. U.S. National Library of Medicine.
  2. ↑ Beyan C, Kaptan K, Beyan E, Turan M (2005). "The platelet count/mean corpuscular hemoglobin ratio distinguishes combined iron and vitamin B12 deficiency from uncomplicated iron deficiency.". Int J Hematol 81 (4): 301-3. DOI:10.1532/IJH97.E0311. PMID 15914358. Research Blogging.
  3. ↑ Wymer A, Becker DM (1990). "Recognition and evaluation of red blood cell macrocytosis in the primary care setting.". J Gen Intern Med 5 (3): 192-7. PMID 2341917. [e]
  4. ↑ Oosterhuis WP, Niessen RW, Bossuyt PM, Sanders GT, Sturk A (2000). "Diagnostic value of the mean corpuscular volume in the detection of vitamin B12 deficiency.". Scand J Clin Lab Invest 60 (1): 9-18. PMID 10757449. [e]
  5. ↑ Seward SJ, Safran C, Marton KI, Robinson SH (1990). "Does the mean corpuscular volume help physicians evaluate hospitalized patients with anemia?". J Gen Intern Med 5 (3): 187-91. DOI:10.1007/BF02600530. PMID 2187961. Research Blogging.
  6. ↑ Ashraf MJ, Cook JR, Rothberg MB (2008). "Clinical utility of folic acid testing for patients with anemia or dementia.". J Gen Intern Med 23 (6): 824-6. DOI:10.1007/s11606-008-0615-z. PMID 18414954. PMC PMC2517884. Research Blogging.
  7. ↑ Naurath HJ, Joosten E, Riezler R, Stabler SP, Allen RH, Lindenbaum J (1995). "Effects of vitamin B12, folate, and vitamin B6 supplements in elderly people with normal serum vitamin concentrations.". Lancet 346 (8967): 85-9. PMID 7603218. [e]
  8. ↑ Matchar DB, McCrory DC, Millington DS, Feussner JR (1994). "Performance of the serum cobalamin assay for diagnosis of cobalamin deficiency.". Am J Med Sci 308 (5): 276-83. PMID 7977446. [e]
  9. ↑ Savage D, Lindenbaum J (1986). "Anemia in alcoholics.". Medicine (Baltimore) 65 (5): 322-38. PMID 3747828. [e]
  10. ↑ Vidal-Alaball J, Butler CC, Cannings-John R, Goringe A, Hood K, McCaddon A et al. (2005). "Oral vitamin B12 versus intramuscular vitamin B12 for vitamin B12 deficiency.". Cochrane Database Syst Rev (3): CD004655. DOI:10.1002/14651858.CD004655.pub2. PMID 16034940. Research Blogging. Review in: Evid Based Med. 2006 Feb;11(1):9
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