hydroxocobalamin and Folic-Acid-Deficiency

Topics: Adult; Aged; Alcoholism; Anemia, Macrocytic; Female; Folic Acid; Folic Acid Deficiency; Humans; Hydroxocobalamin; Hypothyroidism; Infant, Newborn; Liver Failure; Male; Pregnancy; Risk Factors; Time Factors; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Adolescent; Adult; Anemia; Anemia, Hemolytic; Anemia, Hypochromic; Female; Ferritins; Ferrous Compounds; Folic Acid; Folic Acid Deficiency; Humans; Hydroxocobalamin; Iron; Middle Aged; Pregnancy; Pregnancy Complications, Hematologic; Vitamin B 12 Deficiency

Topics: Amblyopia; Carbon Radioisotopes; Cyanides; Cystine; Diet; Erythrocytes; Folic Acid Deficiency; Glutathione; Humans; Hydroxocobalamin; Nicotiana; Optic Nerve; Peripheral Nervous System Diseases; Plants, Toxic; Smoking; Sulfur; Vitamin B 12 Deficiency

Topics: Anemia, Pernicious; Female; Folic Acid Deficiency; Gastritis, Atrophic; Homocysteine; Humans; Hydroxocobalamin; Methylmalonic Acid; Middle Aged; Tetrahydrofolates; Vitamin B 12; Vitamin B Complex

New-onset pancytopenia in pregnancy is challenging in the clinical setting particularly as the management and outcome of pregnancy are entirely dependent on the underlying aetiology. In the absence of increased peripheral destruction, for example, hypersplenism, bone marrow (BM) failure should be considered as the cause of pancytopenia. Profound folate or B12 deficiency may result in BM failure and are relatively easy to diagnose and manage. Other causes include aplastic anaemia (AA), infiltration by a haematological malignancy and other non-haematological disorders. We report a 26-year-old woman presenting with severe pancytopenia due to folate deficiency with complete recovery observed after folic acid replacement. This case highlights the importance of recognising folate deficiency as a reversible cause of pancytopenia, since prompt replacement can lead to rapid normalisation of counts with no subsequent clinical sequelae. We also consider the indications for measuring serum folate in pregnancy.

Topics: Adult; Combined Modality Therapy; Erythrocyte Transfusion; Female; Folic Acid; Folic Acid Deficiency; Hematinics; Humans; Hydroxocobalamin; Pancytopenia; Platelet Transfusion; Pregnancy; Pregnancy Complications; Pregnancy Outcome

The clinical picture is the most important factor in assessing the significance of test results assessing cobalamin status because there is no 'gold standard' test to define deficiency. Serum cobalamin currently remains the first-line test, with additional second-line plasma methylmalonic acid to help clarify uncertainties of underlying biochemical/functional deficiencies. Serum holotranscobalamin has the potential as a first-line test, but an indeterminate 'grey area' may still exist. Plasma homocysteine may be helpful as a second-line test, but is less specific than methylmalonic acid. The availability of these second-line tests is currently limited. Definitive cut-off points to define clinical and subclinical deficiency states are not possible, given the variety of methodologies used and technical issues, and local reference ranges should be established. In the presence of discordance between the test result and strong clinical features of deficiency, treatment should not be delayed to avoid neurological impairment. Treatment of cobalamin deficiency is recommended in line with the British National Formulary. Oral therapy may be suitable and acceptable provided appropriate doses are taken and compliance is not an issue. Serum folate offers equivalent diagnostic capability to red cell folate and is the first-line test of choice to assess folate status.

Topics: Biomarkers; Diagnosis, Differential; Folic Acid; Folic Acid Deficiency; Humans; Hydroxocobalamin; Vitamin B 12 Deficiency

Topics: Administration, Oral; Female; Folic Acid Deficiency; Humans; Hydroxocobalamin; Injections, Intramuscular; Pregnancy; Treatment Outcome; Vitamin B 12; Vitamin B 12 Deficiency

We report here a case of megaloblastic anaemia in late pregnancy, which leads us to question whether folate supplements should be recommended in the UK routinely throughout pregnancy and not just in the preconception period and first trimester.

Topics: Adult; Anemia, Megaloblastic; Female; Folic Acid; Folic Acid Deficiency; Humans; Hydroxocobalamin; Pregnancy; Pregnancy Complications, Hematologic; Vitamin B Complex

Vitamin B12 and folate deficiencies are the main nutritional determinants of hyperhomocysteinemia, which is an independent risk factor for cardiovascular diseases. There is scarce information about nutritional status on vitamin B12 and serum levels of folate in Mexican older people. The objective was to evaluate the nutritional status of vitamin B12 and folic acid concentration in non-institutionalized, urban elderly men and women subjects. One hundred volunteers over 60 years were included in this cross-sectional study. Serum levels of vitamin B12 and folate were measured. In addition some biochemical and anthropometric indicators were also evaluated. Considering serum values of vitamin, 30% had vitamin B12 deficiency, 52% normal status and 18% with high levels. None subjects had folic acid deficiency, by the contrary, a high proportion (62%) showed elevated levels in serum. There was an effect of sex on vitamin B12 status. Elderly men showed significantly lower levels of vitamin B12, and it was according with significant higher prevalence of vitamin B12 deficiency in this group as compared with the women group. The high proportion of vitamin B12 deficiency found in this study underline a possible public health problem and guarantee further survey-studies about vitamin B12 status and to explore causes and consequences of the deficiency. Finally, due the sample size and the design of the study, the results must be seen with caution and not try to generalize.

Topics: Aged; Body Mass Index; Cardiovascular Diseases; Epidemiologic Methods; Female; Folic Acid Deficiency; Humans; Hydroxocobalamin; Hyperhomocysteinemia; Male; Mexico; Middle Aged; Nutritional Status; Sex Distribution; Sex Factors; Urban Population; Vitamin B 12 Deficiency

Topics: Adult; Feeding Behavior; Folic Acid; Folic Acid Deficiency; Humans; Hydroxocobalamin; Male; Retinal Hemorrhage

In 28 patients suffering from subacute combined degeneration of the spinal cord, vitamin B12 metabolism was investigated. Two postulates, proving vitamin B12 deficiency and excluding another cause for the clinical symptoms, have to be fulfilled. Two patients had no disturbance in their vitamin B12 metabolism. Seven patients had a distinct vitamin B12 deficiency. In the remaining 19 patients we found a mild vitamin B12 deficiency. Of these patients, 5 had had a subtotal gastrectomy, one had had a low absorption of vitamin B12, and 13 patients we could not find a distinct cause for the vitamin B12 deficiency. It is not impossible that nutritional habits can be hold responsible for this deficiency. The question whether these 13 patients should be treated with vitamin B12 for the rest of their lives is difficult to answer. It is a conditio sine qua non that in the patients with S.C.D. the vitamin B12 metabolism is examined circumstantially. By so doing, it may be possible to detect, in cases with minor clinical signs and symptoms of S.C.D., the cause of their illness.

Topics: Adult; Aged; Diagnosis, Differential; Female; Folic Acid; Folic Acid Deficiency; Follow-Up Studies; Humans; Hydroxocobalamin; Intestinal Absorption; Male; Middle Aged; Nerve Degeneration; Recurrence; Spinal Cord; Spinal Cord Diseases; Vitamin B 12; Vitamin B 12 Deficiency

The concentrations of vitamin B12 in the sera from 77 patients diagnosed as suffering from the toxic optic neuropathy associated with tobacco smoking were compared with control levels and with serum folic acid concentrations from the same patients. Of these, 17 patients had associated pernicious anaemia. Serum vitamin B12 levels were significantly lower, whereas the folic acid concentrations showed great variation. Folic acid levels in the serum tended to be high when the vitamin B12 level was low (r = 0.29). The results suggest that the role of folic acid in the genesis of the optic neuropathy is not marked. However persistently low levels of folic acid occurred in one subject and significant clinical improvement resulted only from specific therapy.

Topics: Adult; Aged; Anemia, Pernicious; Female; Folic Acid; Folic Acid Deficiency; Humans; Hydroxocobalamin; Male; Middle Aged; Optic Nerve Diseases; Smoking; Visual Acuity; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Adolescent; Adult; Anemia, Macrocytic; Anemia, Pernicious; Carbonic Anhydrases; Electrophoresis; Erythrocytes; Female; Folic Acid Deficiency; Humans; Hydroxocobalamin; Isoenzymes; Male; Middle Aged; Spectrophotometry; Time Factors; Vitamin B 12 Deficiency

Topics: Anemia, Macrocytic; Anemia, Pernicious; Blood Cell Count; Diet, Vegetarian; Drug-Related Side Effects and Adverse Reactions; Folic Acid; Folic Acid Deficiency; Humans; Hydroxocobalamin; Intestinal Diseases; Potassium; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Aged; Anemia; Anemia, Aplastic; Anemia, Hemolytic; Anemia, Hypochromic; Blood Transfusion; Diet; Female; Folic Acid; Folic Acid Deficiency; Humans; Hydroxocobalamin; Iron; Male; Middle Aged; Vitamin B 12 Deficiency

Topics: Adolescent; Adult; Aged; Anemia, Pernicious; Autoradiography; Chromatography, Thin Layer; Diet, Vegetarian; Female; Folic Acid Deficiency; Humans; Hydroxocobalamin; Intestinal Diseases; Leukemia; Liver; Liver Cirrhosis; Liver Diseases; Male; Middle Aged; Postgastrectomy Syndromes; Vitamin B 12; Vitamin B 12 Deficiency