Does an Elevated Serum Vitamin B₁₂ Level Mask Actual Vitamin B₁₂ Deficiency in Myeloproliferative Disorders?

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• 作者：Dron Gauchan ; Nitin Joshi ; Am ; eep Singh Gill ; Vishal Patel ; Vincent A. DeBari ; Gunwant Guron ; Michael Maroules
• 关键词：Cobalamin ; Methylmalonic acid ; Myeloproliferative disorders ; Vitamin B12
• 刊名：Clinical Lymphoma Myeloma and Leukemia
• 出版年：2012
• 出版时间：August, 2012
• 年：2012
• 卷：12
• 期：4
• 页码：269-273
• 全文大小：401 K

文摘

In patients with myeloproliferative disorders, normal to high serum vitamin B₁₂ concentrations have often been reported. The primary objective of this study was to determine whether normal or elevated serum vitamin B₁₂ levels in myeloproliferative disorders might actually mask the true underlying vitamin B₁₂ deficiency in some patients. Thirty-three patients (12 men, 21 women; mean age, 70.55 years [range, 37-90 years]) with polycythemia vera (n = 13), essential thrombocythemia (n = 12), chronic myelogenous leukemia (n = 5), and idiopathic myelofibrosis (IMF) (n = 3) were accrued over a period of 1 year, from March 2009 to February 2010. From all of the subjects, serum vitamin B₁₂ level, methylmalonic acid level, a basic complete blood cell count panel, and liver and renal function tests were obtained. Normal to elevated serum vitamin B₁₂ levels were recorded in all the patients. However, elevated serum methylmalonic acid levels were found in 9 (27.27 % ) patients, with a prevalence of 2 patients with polycythemia vera, 23 % in polycythemia vera, 4 patients with essential thrombocythemia, 33.3 % in essential thrombocythemia, 1 patient with chronic myelogenous leukemia, 20 % in chronic myelogenous leukemia, and 2 patients with idiopathic myelofibrosis, 66.7 % in IMF. Our data suggest that 27.27 % of the total enrolled patients had occult vitamin B₁₂ deficiency despite normal to elevated vitamin B₁₂ levels on regular serum vitamin B₁₂ testing.