The limited value of methylmalonic acid, homocysteine and holotranscobalamin in the diagnosis of early B12 deficiency

Goringe, Andrew, Ellis, Richard, McDowell, Ian Frederick, Vidal-Alaball, Josep ORCID: https://orcid.org/0000-0002-3527-4242, Jenkins, Christopher, Butler, Christopher Collett ORCID: https://orcid.org/0000-0002-0102-3453 and Worwood, Mark 2006. The limited value of methylmalonic acid, homocysteine and holotranscobalamin in the diagnosis of early B12 deficiency. Haematologica 91 (2) , pp. 231-234.

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Abstract

Treatment of B12 deficiency is important to prevent progressive neurological and/or hematologic disease but requires a secure diagnosis. The aim of this study was to evaluate second line tests of B12 status as prognostic indicators of a hematologic response to vitamin B12 therapy. Forty-nine patients referred with low, serum vitamin B12 concentrations were treated with intramuscular B12 and re-assessed after 3 months. Methylmalonic acid, homocysteine, holotranscobalamin and neutrophil hypersegmentation index were measured before and after treatment. Before treatment 27/49 patients were anemic or macrocytic of whom 15 had a clear hematologic response. All the tests had a similar prognostic accuracy. Symptomatic improvement did not correlate with hematologic response. Supplementary tests of vitamin B12 status were not significantly better than total serum B12 concentration as predictors of a hematologic response to vitamin B12 therapy.

Item Type:	Article
Date Type:	Publication
Status:	Published
Schools:	Medicine Systems Immunity Research Institute (SIURI)
Subjects:	R Medicine > R Medicine (General)
Publisher:	Ferrata Storti Foundation
ISSN:	0390-6078
Last Modified:	25 Oct 2022 09:40
URI:	https://orca.cardiff.ac.uk/id/eprint/59580

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