vitamin-b-12 and Anemia

The present review focuses on the side effects that ex-obese patients face following bariatric surgery. We searched through the principal medical indexes (SCOPUS, Web of Science, PubMed, MEDLINE) using the following words, both alone and in combinations: bariatrics; bariatric surgery; anemia; vitamin B12; cobalamin; folate; folic acid; iron; iron supplements; gut microbiota; lactalbumin; α-lactalbumin. To perform exhaustive research, we considered articles published since 1985. Bariatric surgery induces states of nutritional deficiencies. In particular, the surgery results in a drastic fall in the levels of iron, cobalamin, and folate. Despite the dietary supplements which can counteract such decrease, some limitations exist in the nutraceutical approach. Indeed, the gastrointestinal side effects of supplements, the alterations in the microbiota, and the reduced absorption induced by the surgery may impair the effect of dietary supplements, exposing the patients to the risk of developing nutritional deficiencies. Recent literature reports the effect of promising molecules to counteract such limitations, which include α-lactalbumin, a whey protein with prebiotic activities, and new pharmaceutical forms of iron supplements, namely micronized ferric pyrophosphate. If on the one hand, α-lactalbumin enhances intestinal absorption and helps in restoring a physiological microbiota, micronized ferric pyrophosphate has a high tolerability and low or null risk of gastrointestinal side effects. Bariatric surgery represents a valid solution to obesity and obesity-related disease. However, the procedure may induce deficiencies in micronutrients. Data exists on the promising activities of α-lactalbumin and micronized ferric pyrophosphate, which may help in preventing bariatric-induced anemia.

Topics: Anemia; Bariatric Surgery; Dietary Supplements; Folic Acid; Humans; Iron; Lactalbumin; Malnutrition; Obesity; Obesity, Morbid; Vitamin B 12

Anemia and depression are common in the elderly and they are important medical, social and economic problems for the world. Both disorders are associated with a lower quality of life, multimorbidity and a higher risk of death. The connections between anemia and depression have been reported, but the mechanism and clinical consequences of their co-existence are not fully understood. Several links can be found between anemia and depression in the elderly: common etiological factors, low socioeconomic status of patients, poor education and less physical activity. Both conditions are associated with the occurrence of the same pathological changes: age-related (especially with the presence of inflammation, oxidative stress, degenerative changes in organs and tissues), nutritional deficiencies (iron, vitamin B12, folic acid) and hormonal disorders (especially thyroid gland disorders, sex hormone deficiencies). Anemia and depression are not sufficiently diagnosed in the elderly and, as a result, are often left untreated. The diagnosis and treatments of these conditions in the elderly differ from those in other age groups. The study provides an overview of the literature regarding the co-existence of anemia and depression in elderly patients and clinical recommendations.

Topics: Aged; Anemia; Depression; Folic Acid Deficiency; Humans; Quality of Life; Vitamin B 12; Vitamin B 12 Deficiency

Although Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) are the most prevalent bariatric surgical procedures, high-level evidence is scarce regarding the assessment of postoperative nutritional risk in RYGB versus SG. Therefore, we performed a systematic review and meta-analysis to compare the risk of anemia and related micronutrient deficiencies after RYGB and SG. We analyzed 10 randomized controlled trials that compared RYGB and SG with reported incidence of postoperative anemia and/or anemia-related micronutrient deficiencies (iron, vitamin B

Topics: Anemia; Folic Acid; Gastrectomy; Gastric Bypass; Humans; Malnutrition; Micronutrients; Obesity; Obesity, Morbid; Randomized Controlled Trials as Topic; Retrospective Studies; Vitamin B 12; Vitamins

Folic acid, referred to as vitamin B9, is a water-soluble substance, which participates in the synthesis of nucleic acids, amino acids, and proteins. Similarly to B12 and B6, vitamin B9 is involved in the metabolism of homocysteine, which is associated with the

Topics: Anemia; Dietary Supplements; Folic Acid; Folic Acid Deficiency; Gastrointestinal Microbiome; Humans; Hyperhomocysteinemia; Inflammatory Bowel Diseases; Methylenetetrahydrofolate Reductase (NADPH2); Vitamin B 12; Vitamin B 6

Bariatric surgery may increase the risk of iron, vitamin B

Topics: Anemia; Bariatric Surgery; Copper; Folic Acid; Gastric Bypass; Humans; Iron; Obesity, Morbid; Vitamin B 12; Vitamin B 12 Deficiency; Vitamins

Atrophic glossitis (AG) is characterized by the partial or complete absence of filiform papillae on the dorsal surface of the tongue. AG may reflect the significant deficiencies of some major nutrients including riboflavin, niacin, pyridoxine, vitamin B12, folic acid, iron, zinc, and vitamin E. Moreover, protein-calorie malnutrition, candidiasis, Helicobacter pylori colonization, xerostomia, and diabetes mellitus are also the etiologies of AG. Our previous study found the serum gastric parietal cell antibody (GPCA), thyroglobulin antibody (TGA), and thyroid microsomal antibody (TMA) positivities in 26.7%, 28.4%, and 29.8% of 1064 AG patients, respectively. We also found anemia, serum iron, vitamin B12, and folic acid deficiencies, and hyperhomocysteinemia in 19.0%, 16.9%, 5.3%, 2.3%, and 11.9% of 1064 AG patients, respectively. Moreover, GPCA-positive AG patients tended to have relatively higher frequencies of hemoglobin, iron, and vitamin B12 deficiencies and hyperhomocysteinemia than GPCA-negative AG patients. Supplementations with vitamin BC capsules plus corresponding deficient hematinics for those AG patients with hematinic deficiencies can achieve complete remission of oral symptoms and AG in some AG patients. Therefore, it is very important to examine the complete blood count, serum hematinic, homocysteine, and autoantibody levels in AG patients before we start to offer treatments for AG patients.

Topics: Anemia; Atrophy; Autoantibodies; Erythrocyte Indices; Folic Acid; Folic Acid Deficiency; Glossitis; Hemoglobins; Humans; Hyperhomocysteinemia; Iron; Parietal Cells, Gastric; Vitamin B 12; Vitamin B 12 Deficiency

Recurrent aphthous stomatitis (RAS) is one of the most common oral mucosal diseases characterized by recurrent and painful ulcerations on the movable or nonkeratinized oral mucosae. Clinically, three types of RAS, namely minor, major, and herpetiform types, can be identified. RAS more commonly affects labial mucosa, buccal mucosa, and tongue. Previous studies indicate that RAS is a multifactorial T cell-mediated immune-dysregulated disease. Factors that modify the immunologic responses in RAS include genetic predisposition, viral and bacterial infections, food allergies, vitamin and microelement deficiencies, systemic diseases, hormonal imbalance, mechanical injuries, and stress. Our previous study found the presence of serum gastric parietal cell antibody, thyroglobulin antibody, and thyroid microsomal antibody in 13.0%, 19.4%, and 19.7% of 355 RAS patients, respectively. We also found anemia, serum iron, vitamin B12, and folic acid deficiencies, and hyperhomocysteinemia in 20.9%, 20.1%, 4.8%, 2.6%, and 7.7% of 273 RAS patients, respectively. Therefore, it is very important to examine the complete blood count, serum autoantibody, hematinic, and homocysteine levels in RAS patients before we start to offer treatments for RAS. Because RAS is an immunologically-mediated disease, topical and systemic corticosteroid therapies are the main treatments of choice for RAS.

Topics: Anemia; Autoantibodies; Erythrocyte Indices; Folic Acid; Hematinics; Hemoglobins; Humans; Hyperhomocysteinemia; Iron; Parietal Cells, Gastric; Recurrence; Stomatitis, Aphthous; Vitamin B 12

Metformin is first-line therapy for patients with diabetes. However, it may lower vitamin B. PubMed, Web of Knowledge, Cochrane Library, and Embase were searched to identify all relevant studies published in English prior to March 2018. Pooled risk ratios (RRs) and 95% confidence intervals (CIs) were calculated for dichotomous outcomes and pooled mean differences (MDs) and 95% CIs were calculated for continuous outcomes.. Thirty-one studies were included in the meta-analyses. Compared with diabetic patients not taking metformin, patients taking metformin had a significantly higher risk of vitamin B. Metformin use led to significantly lowered vitamin B. 摘要: 背景 二甲双胍是糖尿病患者的一线治疗药物。然而, 二甲双胍的使用与维生素B

Topics: Anemia; Case-Control Studies; Diabetes Mellitus, Type 2; Humans; Hypoglycemic Agents; Metformin; Peripheral Nervous System Diseases; Prognosis; Vitamin B 12; Vitamin B Complex

Low vitamin B12 and folate levels in community-dwelling older people are usually corrected with supplements. However, the effect of this supplementation on haematological parameters in older persons is not known. Therefore, we executed a systematic review and individual participant data meta-analysis of randomised placebo-controlled trials (RCTs).. We performed a systematic search in PubMed, EMBASE, Web of Science, Cochrane and CENTRAL for RCTs published between January 1950 and April 2016, where community-dwelling elderly (60+ years) who were treated with vitamin B12 or folic acid or placebo. The presence of anaemia was not required. We analysed the data on haematological parameters with a two-stage IPD meta-analysis.. We found 494 full papers covering 14 studies. Data were shared by the authors of four RCTs comparing vitamin B12 with placebo (n = 343) and of three RCTs comparing folic acid with placebo (n = 929). We found no effect of vitamin B12 supplementation on haemoglobin (change 0.00 g/dL, 95% CI: -0.19;0.18), and no effect of folic acid supplementation (change -0.09 g/dL, 95% CI: -0.19;0.01). The effects of supplementation on other haematological parameters were similar. The effects did not differ by sex or by age group. Also, no effect was found in a subgroup of patients with anaemia and a subgroup of patients who were treated >4 weeks.. Evidence on the effects of supplementation of low concentrations of vitamin B12 and folate on haematological parameters in community-dwelling older people is inconclusive. Further research is needed before firm recommendations can be made concerning the supplementation of vitamin B12 and folate.

Topics: Aged; Aged, 80 and over; Anemia; Female; Folic Acid; Hemoglobins; Humans; Male; Middle Aged; Randomized Controlled Trials as Topic; Vitamin B 12

The interdisciplinary symposium of the working group "anemia in the aged" on the occasion of the annual conference of the German Society of Geriatrics focused this year on vitamin B

Topics: Aged; Aging; Anemia; Congresses as Topic; Female; Geriatric Assessment; Germany; Hematology; Humans; Societies, Medical; Vitamin B 12; Vitamin B 12 Deficiency; Vitamins

Anemia of pregnancy, an important risk factor for fetal and maternal morbidity, is considered a global health problem, affecting almost 50% of pregnant women. In this article, diagnosis and management of iron, cobalamin, and folate deficiencies, the most frequent causes of anemia in pregnancy, are discussed. Three clinical cases are considered. Iron deficiency is the most common cause. Laboratory tests defining iron deficiency, the recognition of developmental delays and cognitive abnormalities in iron-deficient neonates, and literature addressing the efficacy and safety of IV iron in pregnancy are reviewed. An algorithm is proposed to help clinicians diagnose and treat iron deficiency, recommending oral iron in the first trimester and IV iron later. Association of folate deficiency with neural tube defects and impact of fortification programs are discussed. With increased obesity and bariatric surgery rates, prevalence of cobalamin deficiency in pregnancy is rising. Low maternal cobalamin may be associated with fetal growth retardation, fetal insulin resistance, and excess adiposity. The importance of treating cobalamin deficiency in pregnancy is considered. A case of malarial anemia emphasizes the complex relationship between iron deficiency, iron treatment, and malaria infection in endemic areas; the heightened impact of combined etiologies on anemia severity is highlighted.

Topics: Adult; Anemia; Anemia, Iron-Deficiency; Erythrocyte Transfusion; Female; Folic Acid; Folic Acid Deficiency; Hematinics; Humans; Iron; Pregnancy; Pregnancy Complications; Pregnancy Complications, Hematologic; Vitamin B 12; Vitamin B 12 Deficiency; Vitamin B Complex

Patients with microcytosis (defined as mean corpuscular volume < 80 fL) are not uncommonly found in oral mucosal disease clinics. This study assessed the anemia statuses and hematinic deficiencies in 240 oral mucosal disease patients with microcytosis.. The mean red blood cell (RBC) count, mean corpuscular volume, and RBC distribution width, as well as blood concentrations of hemoglobin (Hb), iron, vitamin B12, folic acid, and homocysteine in 240 microcytosis patients and in 240 age- and sex-matched healthy control individuals were measured and compared.. We conclude that approximately 45%, 4%, and 5% of microcytosis patients have iron, vitamin B12, and folic acid deficiencies, respectively, and approximately 10% of microcytosis patients have abnormally high homocysteine levels. Moreover, 67.5% of 240 microcytosis patients and 50.8% of 120 TT patients had anemia. Iron deficiency anemia is the most common type of anemia in microcytosis patients, followed by TT-induced anemia and other microcytic anemia.

Topics: Anemia; Erythrocyte Count; Erythrocyte Indices; Humans; Mouth Diseases; Vitamin B 12

In the elderly, even mild anaemia leads to significantly decreased quality of life and reduced survival rate. Therefore even mild anaemias should be worked up especially in the elderly. More than 75 % of all anaemias have a specific and treatable cause.Differential diagnosis of anaemia in the elderly is much more challenging compared to the differential diagnosis in younger patients: in older patients often more than one dysfunction is responsible for the anaemia simultaneously. Many routine laboratory parameters are changed by ageing and are therefore only of limited value for diagnosis of anaemia. Soluble transferinreceptor and hepcidin are two parameters feasible for differential diagnosis of the causes of anaemia in the elderly.The most common cause of iron deficiency anaemia in the elderly is gastrointestinal bleeding. Many causes for gastrointestinal bleeding -like angiodysplasia of the colon - can readily be treated with endoscopic therapy. For this reason, colonoscopy is part of the standard workup for elderly patients with iron-deficient anaemia (IDA) if no contraindications exist.Therapy of anaemia is based on the specific cause or the causes. In IDA, the first step other than causal treatment is to replace iron orally. If this is not tolerated because of side effects or does not lead to a sufficient rise in the haemoglobin level, intravenous iron replacement therapy is indicated. Folic acid deficiency is generally treated orally, whereas vitamin B12 deficiency is generally treated by the parenteral - preferably subcutaneous - route. In anaemia due to chronic renal failure and anaemia due to myelodysplastic syndromes, the underlying cause must be treated, furthermore erythropoiesis-stimulating agents can be indicated.

Topics: Aged; Aged, 80 and over; Anemia; Clinical Laboratory Techniques; Diagnosis, Differential; Evidence-Based Medicine; Female; Geriatric Assessment; Hematinics; Humans; Iron; Male; Physical Examination; Quality of Life; Treatment Outcome; Vitamin B 12

Anemia is one of the commonest extraintestinal manifestations of inflammatory bowel disease (IBD). The pathogenesis of anemia in IBD is complex but iron deficiency combined with inflammation is the most common factor related to the development of anemia. However, other causes such as vitamin B12 and folate deficiency, hemolysis, myelosuppression and drug also should not be overlooked. In addition to ferritin, inflammatory markers and new biochemical parameters such as hepcidin and ferritin index are being tested as diagnostic a tool. First step for treatment is disease activity control and iron supplementation. Although oral iron is widely used, intravenous iron therapy should be considered in patients who are intolerant to oral iron therapy, have severe and refractory anemia or are in active disease state. Recently, new intravenous iron formulations have been introduced and due to their safety and easy usage, they have become the standard treatment modality for managing anemia in IBD. Erythropoietin and transfusion can be considered in specific situations. Vitamin B12 and folate supplementation is also important in patients who are deficient of these micronutrients. Since anemia in IBD patients could significantly influence the disease outcome, further studies and standard guideline for IBD are needed.

Topics: Anemia; Biomarkers; Ferritins; Hepcidins; Humans; Inflammatory Bowel Diseases; Iron; Vitamin B 12

Nutritional anemia is the most common type of anemia, affecting millions of people in all age groups worldwide. While inadequate access to food and nutrients can lead to anemia, patients with certain health status or medical conditions are also at increased risk of developing nutritional anemia. Iron, cobalamin, and folate are the most recognized micronutrients that are vital for the generation of erythrocytes. Iron deficiency is associated with insufficient production of hemoglobin. Deficiency of cobalamin or folate leads to impaired synthesis of deoxyribonucleic acid, proteins, and cell division. Recent research has demonstrated that the status of copper and zinc in the body can significantly affect iron absorption and utilization. With an increasing number of patients undergoing bariatric surgical procedures, more cases of anemia associated with copper and zinc deficiencies have also emerged. The intestinal absorption of these 5 critical micronutrients are highly regulated and mediated by specific apical transport mechanisms in the enterocytes. Health conditions that persistently alter the histology of the upper intestinal architecture, expression, or function of these substrate-specific transporters, or the normal digestion and flow of these key micronutrients, can lead to nutritional anemia. The focus of this article is to review the science of intestinal micronutrient absorption, discuss the clinical assessment of micronutrient deficiencies in relation to anemia, and suggest an effective treatment plan and monitoring strategies using an evidence-based approach.

Topics: Anemia; Copper; Dietary Supplements; Evidence-Based Medicine; Folic Acid; Humans; Intestinal Absorption; Iron, Dietary; Micronutrients; Vitamin B 12; Zinc

There have been several large-scale epidemiologic studies, including the National Health and Nutrition Examination Survey III (NHANES III), which have described the prevalence and impact of anemia in the elderly. The information derived has been critically important. However, given the large number of patients surveyed, these reports necessarily relied substantially on the laboratory-based screening evaluations. There are now two recent reports describing the cause of anemia in elderly outpatients, and although the numbers are smaller than the large scale surveys, they constitute comprehensive hematologic evaluations with therapeutic interventions and clinical follow-up. The purpose of this review is to compare these different analyses.. There are distinct differences and similarities in the two types of studies, which are derived from patients seen in hematology clinics. Despite comprehensive hematologic evaluation, the puzzling entity of unexplained anemia of the elderly is confirmed and found to account for 30-46% of patients. NHANES III classified iron-deficiency anemia with other nutritional anemias, a classification that might be correct in the developing third world, but in North America and Western Europe, iron deficiency is more often caused by blood loss and the cause must be sought and dealt with. The myelodysplastic syndromes are an important cause of anemia in the elderly, with a prevalence of at least 4%.. Large-scale screening studies of anemia in the elderly are of great importance, and when complemented by comprehensive hematologic evaluations, provide a more accurate picture of the clinical situation.

Topics: Aged; Aged, 80 and over; Anemia; Blood Cell Count; Folic Acid; Health Surveys; Hemoglobins; Humans; Iron; Iron Deficiencies; Iron, Dietary; Myelodysplastic Syndromes; Nutrition Assessment; Outpatients; Vitamin B 12

Anaemia is a major global health problem. Although the main cause is iron deficiency, anaemia also results from other nutritional deficiencies (folate and vitamin B12), haemolytic disorders including haemoglobinopathies, and bone marrow disorders. Accurate diagnosis of anaemia is dependent on reliable diagnostic tests and reference ranges, which in turn are dependent on effective standardisation. Standardisation is achieved through the availability of reference materials and reference measurement procedures. International biological reference materials have therefore been developed to standardise and control diagnostic tests for anaemia for a diverse range of analytes including total haemoglobin and haemoglobin types, ferritin, the serum transferrin receptor, serum vitamin B12 and folate, whole blood folate, and alloantibodies which mediate immune haemolytic anaemia.

Topics: Anemia; Ferritins; Folic Acid; Hemoglobins; Humans; International Cooperation; Receptors, Transferrin; Reference Standards; Sensitivity and Specificity; Vitamin B 12

Anemia is a frequent finding in most diseases which cause malabsorption. The most frequent etiology is the combination of iron and vitamin B12 deficiency. Celiac disease is frequently diagnosed in patients referred for evaluation of iron deficiency anemia (IDA), being reported in 1.8%-14.6% of patients. Therefore, duodenal biopsies should be taken during endoscopy if no obvious cause of iron deficiency (ID) can be found. Cobalamin deficiency occurs frequently among elderly patients, but it is often unrecognized because the clinical manifestations are subtle; it is caused primarily by food-cobalamin malabsorption and pernicious anemia. The classic treatment of cobalamin deficiency has been parenteral administration of the vitamin. Recent data suggest that alternative routes of cobalamin administration (oral and nasal) may be useful in some cases. Anemia is a frequent complication of gastrectomy, and has been often described after bariatric surgery. It has been shown that banding procedures which maintain digestive continuity with the antrum and duodenum are associated with low rates of ID. Helicobacter pylori (H. pylori) infection may be considered as a risk factor for IDA, mainly in groups with high demands for iron, such as some children and adolescents. Further controlled trials are needed before making solid recommendations about H. pylori eradication in these cases.

Topics: Anemia; Anemia, Iron-Deficiency; Celiac Disease; Gastrectomy; Helicobacter Infections; Humans; Iron Deficiencies; Malabsorption Syndromes; Parenteral Nutrition; Vitamin B 12; Vitamin B 12 Deficiency

Based on biochemical evidence, a high prevalence of biochemical evidence of vitamin B12 or folate deficiency has been reported in a number of areas in the world. The evidence that these biochemical abnormalities lead to a comparable prevalence of anemia is reviewed. The overall contribution of vitamin B12 deficiency to the global burden of anemia is probably not significant, except perhaps in women and their infants and children in vegetarian communities. In developed countries, folate-deficiency anemia is uncommon. In some developing countries, this anemia is still seen, but there are no comprehensive data on the relative prevalence compared with anemia due to malaria, iron-deficiency, hemoglobinopathy, and HIV disease. It seems unlikely that folate deficiency makes a major contribution to the burden of anemia in developing countries. Iron-deficiency anemia may coexist with vitamin B12 and especially folate deficiency, and may confound the hematological features of the vitamin deficiencies whose prevalence would then be underestimated. Supplementation of the diet of pregnant women with folic acid can virtually eliminate folate-deficiency anemia in these women. There are very few data on the hematological effect of vitamin B12 supplementation or fortification at the population level. The addition of vitamin B12 to the supplementation of the diet of pregnant women with iron and folic acid does not produce an increased hematological response, at least in nonvegetarian populations. There are numerous reports of the effect of folic acid fortification of food on tests of folate status, but only a single published report on the hematological response was found.

Topics: Anemia; Comorbidity; Developing Countries; Dietary Supplements; Female; Folic Acid; Folic Acid Deficiency; Food, Fortified; Humans; Nutrition Assessment; Nutritional Requirements; Nutritional Status; Pregnancy; Pregnancy Complications; Prevalence; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Anemia; Biomarkers; Chronic Disease; Erythropoietin; Evidence-Based Medicine; Folic Acid; Hematinics; Hemoglobins; Humans; Iron; Kidney Diseases; Recombinant Proteins; Treatment Outcome; Vitamin B 12

Nutritional anemias are important because they are easily reversed and because their underlying causes, most often unrelated to dietary intake, require individualized assessment. Iron-deficiency anemia (IDA) usually results from iron losses accompanying chronic bleeding, including loss to intestinal parasites, or from gastric disorders or malabsorption in the elderly. Cobalamin-deficiency anemia, the only nutritional anemia with predilection for the elderly, nearly always stems from failure of intrinsic factor (IF)-related absorption. Folate-deficiency anemia, the only nutritional anemia usually caused by poor intake, has nearly disappeared in countries that fortify food with folic acid. Copper-deficiency anemia, which usually results from malabsorptive disorders or from medical or nutritional interventions that provide inadequate copper or excess zinc, is uncommon but increasingly recognized. The prevalences of nutritional anemias, which are not always distinguished from non-anemic deficiency, are uncertain. The mean corpuscular volume (MCV) provides an essential diagnostic tool leading to judicious matching of relevant biochemical changes with relevant anemia. Nutritional anemias usually feature abnormal MCV, whereas the predominant anemias in the aged, especially the anemias of chronic disease/chronic inflammation (ACD/ACI), of renal failure, and of unknown causes, are typically normocytic.

Topics: Adult; Aged; Anemia; Anemia, Iron-Deficiency; Erythrocytes; Female; Humans; Iron, Dietary; Male; Middle Aged; Nutrition Disorders; Vitamin B 12; Vitamin B 12 Deficiency

The most common cause of vitamin B12 deficiency in older people is malabsorption of food-bound vitamin B12. Thus, it is suggested that the recommended daily allowance of 2.4 microg/d be met primarily with crystalline vitamin B12, which is believed to be well absorbed in individuals who have food-bound malabsorption. There is concern that high intakes of folic acid from fortified food and dietary supplements might mask the macrocytic anemia of vitamin B12 deficiency, thereby eliminating an important diagnostic sign. One recent study indicates that high serum folate levels during vitamin B12 deficiency exacerbate (rather than mask) anemia and worsen cognitive symptoms. Another study suggests that once vitamin B12 deficiency is established in subjects with food-bound malabsorption, 40 microg/d to 80 microg/d of oral crystalline vitamin B12 for 30 d does not reverse the biochemical signs of deficiency. Together, these studies provide further evidence that public health strategies are needed to improve vitamin B12 status in order to decrease the risk of deficiency and any potentially adverse interactions with folic acid.

Topics: Aging; Anemia; Cognition Disorders; Diagnosis, Differential; Dietary Supplements; Folic Acid; Food, Fortified; Humans; Intestinal Absorption; Nutritional Status; Public Health; Vitamin B 12; Vitamin B 12 Deficiency

Anaemia is a serious complication of Crohn's disease that triggers hospitalization and, if not interfered with, may lead to death.. To systematically summarize and compare the literature on anaemia in Crohn's disease.. For this systematic review the literature was searched for English-language articles using anaemia, Crohn* and IBD as key words. 144 articles were identified and sorted according to the following topics: prevalence, aetiology, diagnostic tests and therapy.. The reported prevalence of anaemia varied between 6.2% and 73.7%, with higher reported frequencies in older studies and in in-patients. Iron deficiency is the most common underlying condition. Vitamin B12 deficiency is related to the extent of ileal resection but has rarely impact on anaemia. Diagnostic criteria are not established and treatment guidelines are missing. Oral iron supplementation seems effective for short periods but intolerance leads to discontinuation in up to 21%. Eleven of 11 studies show that oral iron enhances intestinal inflammation and colon carcinogenesis in animal models of colitis. Intravenous iron supplementation with iron sucrose has been tested in over 250 Crohn's disease patients, is safe, effective and does not carry such hazards.. As disease activity is determining the degree of anaemia in Crohn's disease, implementation of more effective therapy for Crohn's disease will lower its incidence. However, further studies regarding the safety and effectiveness of iron supplementation are needed.

Topics: Anemia; Crohn Disease; Ferric Compounds; Folic Acid; Folic Acid Deficiency; Genetic Predisposition to Disease; Humans; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Anemia; Gastritis, Atrophic; Humans; Liver Diseases; Luminescent Measurements; Myeloproliferative Disorders; Radioligand Assay; Reference Values; Specimen Handling; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Absorption; Anemia; Diagnosis, Differential; Gastrectomy; Humans; Intestinal Diseases, Parasitic; Malabsorption Syndromes; Reference Values; Schilling Test; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Anemia; Bone Marrow; Bone Marrow Transplantation; Diagnosis, Differential; Erythrocyte Volume; Ferritins; Folic Acid; Humans; Immunosuppression Therapy; Iron; Vitamin B 12

Topics: Anemia; Central Nervous System; Folic Acid; Hereditary Sensory and Autonomic Neuropathies; Hereditary Sensory and Motor Neuropathy; Humans; Vitamin B 12

Topics: Anemia; Developing Countries; Folic Acid; Humans; Iron; Nutrition Disorders; Nutritional Requirements; Terminology as Topic; Vitamin B 12

Topics: Anemia; Bone Marrow; Erythrocytes; Erythropoiesis; Erythropoietin; Ferritins; Folic Acid; Hemoglobins; Hemorrhage; Hemostasis; Humans; Hypersplenism; Iron; Kidney Failure, Chronic; Kidney Transplantation; Renal Dialysis; Uremia; Vitamin B 12

The fetus, the neonate, and the pregnant woman have a greater requirement for folic acid and vitamin B12 and are more likely to suffer from a deficiency of these vitamins. This article reviews the source, requirement, absorption, and metabolism of these vitamins and discusses the problems attributed to their deficiency in pregnancy and in the neonatal period.

Topics: Abortion, Spontaneous; Anemia; Congenital Abnormalities; Female; Folic Acid; Folic Acid Deficiency; Humans; Infant, Newborn; Infant, Premature; Intellectual Disability; Neural Tube Defects; Pregnancy; Pregnancy Complications; Pregnancy Complications, Hematologic; Vitamin B 12; Vitamin B 12 Deficiency

A review of nutritional anaemia in Africa is presented above. It has been noted that nutritional anaemia, including iron-deficiency anaemia, megaloblastic anaemia due to folate deficiency or vitamin B12 deficiency, or both, and protein deficiency-anaemia, is widespread throughout Africa. It is particularly common in growing children, women of child-bearing age, pregnant women and lactating mothers. The anaemia is also especially common during the second half of the dry season and the first half of the wet season, when food supplies are limited. In all cases the anaemia is caused either by limited dietary intake, excessive loss of nutrients or excessive utilization. The anaemia is associated with a number of sequelae including both structural changes, like mitochondrial swelling and mucosal atrophy, and functional abnormalities, such as cardiac failure, decreased work output, increased pregnancy risks and increased susceptibility to infections. The evidence in favour of increased susceptibility to infections in megaloblastic anaemia and protein-deficiency anaemia is overwhelming, but in iron-deficiency anaemia the available information argues in favour of reduced susceptibility to infections, except after initiation of iron therapy. The treatment of nutritional anaemia includes replacement of the deficient nutrients (and blood transfusion in severe cases), prevention of further nutrient losses and treatment of associated complications.

Topics: Adult; Africa; Anemia; Anemia, Hypochromic; Anemia, Megaloblastic; Child; Deficiency Diseases; Female; Folic Acid; Folic Acid Deficiency; Humans; Iron; Male; Pregnancy; Protein Deficiency; Tropical Climate; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Anemia; Anemia, Hemolytic; Anemia, Hemolytic, Congenital; Anemia, Hypochromic; Anemia, Macrocytic; Anemia, Megaloblastic; Anemia, Sideroblastic; Chronic Disease; Diagnosis, Differential; Humans; Malabsorption Syndromes; Thalassemia; Vitamin B 12

The role of the metals, iron and copper, and the vitamins E, folic acid, and B12 in the genesis of nutritional anemias in infancy have been reviewed. All are preventable. The precise requirements for each of these trace elements and vitamins in the small premature infant remain to be defined. The nonhematologic consequences of these nutritional deficiencies require further study. Anemia may prove to be the least important manifestation of the deficiency states.

Topics: Adolescent; Anemia; Anemia, Hemolytic; Anemia, Hypochromic; Child; Child, Preschool; Copper; Female; Folic Acid; Folic Acid Deficiency; Growth; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Infant, Premature; Iron; Nutritional Requirements; Pregnancy; Vitamin B 12; Vitamin B 12 Deficiency; Vitamin B Deficiency; Vitamin E; Vitamin E Deficiency

Topics: Anemia; Anemia, Hemolytic; Blood Transfusion; Humans; Iron; Splenectomy; Thymectomy; Vitamin B 12

Topics: Adult; Anemia; Anemia, Hypochromic; Contraceptives, Oral; Deficiency Diseases; Female; Folic Acid; Folic Acid Deficiency; Hemoglobins; Humans; Iron; Iron Deficiencies; Lactation; Male; Menstruation; Middle Aged; Nutritional Requirements; Pregnancy; Pregnancy Complications; Sex Factors; United States; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Absorption; Aged; Anemia; Anemia, Pernicious; Chemical Phenomena; Chemistry; Food Analysis; Gastrointestinal Diseases; Humans; Intrinsic Factor; Malabsorption Syndromes; Transcobalamins; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Adolescent; Adult; Aged; Anemia; Child; Child, Preschool; Female; Humans; Infant; Infant, Newborn; Male; Methods; Middle Aged; Pregnancy; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Adult; Anemia; Anemia, Hypochromic; Deficiency Diseases; Female; Folic Acid; Folic Acid Deficiency; Food, Fortified; Hemoglobins; Humans; International Cooperation; Iron; Male; Pregnancy; Pregnancy Complications; Vitamin B 12

Topics: Adult; Anemia; Animal Feed; Animals; Biological Transport; Body Composition; Child; Cobalt; Deficiency Diseases; Female; Food Analysis; Humans; Iodine; Iron; Liver; Male; Manganese; Nutritional Requirements; Polycythemia; Pregnancy; Thyroid Gland; Vegetables; Vitamin B 12

Topics: Anemia; Anemia, Hypochromic; Diet Therapy; Folic Acid; Humans; Iron; Nutrition Disorders; Riboflavin Deficiency; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Adolescent; Anemia; Animals; Biological Transport; Blind Loop Syndrome; Calcium; Gastric Mucosa; Gastritis; Guinea Pigs; Humans; Hydrogen-Ion Concentration; Ileum; Intestinal Absorption; Intestinal Diseases, Parasitic; Intestinal Mucosa; Intrinsic Factor; Male; Pancreatic Diseases; Radiation Effects; Rats; Thalassemia; Trypsin; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Anemia; Anemia, Hypochromic; Anemia, Macrocytic; Anemia, Sickle Cell; Child; Child, Preschool; Feces; Female; Fever; Folic Acid; Hemoglobinopathies; Hookworm Infections; Humans; Infant; Leishmaniasis, Visceral; Malaria; Male; Pregnancy; Protozoan Infections; Schistosomiasis; Vitamin B 12

Topics: Anemia; Anemia, Hemolytic; Blood Circulation; Bone Marrow; Catalase; Erythrocytes; Ferritins; Hemoglobins; Hemolysis; Hemorrhage; Humans; Iron; Metals; Mononuclear Phagocyte System; Neoplasm Metastasis; Neoplasms; Polysaccharides, Bacterial; Regional Blood Flow; Vitamin B 12

Topics: Anemia; Anemia, Hemolytic; Anemia, Hemolytic, Congenital Nonspherocytic; Anemia, Hypochromic; Anemia, Macrocytic; Blood Transfusion; Erythropoiesis; Glucocorticoids; Humans; Iron; Vitamin B 12

Topics: Anemia; Anemia, Hypochromic; Anemia, Macrocytic; Anemia, Sideroblastic; Arthritis, Rheumatoid; Bone Marrow; Cobalt; Erythrocytes; Female; Folic Acid; Folic Acid Deficiency; Gastric Acidity Determination; Hemoglobinometry; Humans; Intestinal Absorption; Iron; Liver Extracts; Male; Mononuclear Phagocyte System; Plasma Volume; Potassium; Salicylates; Sex Factors; Steroids; Vitamin B 12

Topics: Abetalipoproteinemia; Adult; Anemia; Anemia, Macrocytic; Animals; Ascorbic Acid; Bone Marrow; Deficiency Diseases; Dietary Fats; DNA Replication; Erythropoiesis; Humans; Infant; Infant, Newborn; Infant, Premature, Diseases; Iron; Kwashiorkor; RNA; Salmonidae; Selenium; Swine; Vitamin B 12; Vitamin E; Vitamin E Deficiency

Topics: Anemia; Anemia, Hemolytic, Congenital; Anemia, Myelophthisic; Anemia, Pernicious; Chromium Isotopes; Cobalt Isotopes; Diagnosis, Differential; Erythrocyte Aging; Glucosephosphate Dehydrogenase Deficiency; Humans; Intestinal Absorption; Iron Isotopes; Phosphorus Isotopes; Radioisotopes; Vitamin B 12

Topics: Anemia; Anemia, Macrocytic; Celiac Disease; Diagnosis; Diarrhea; Humans; Intestinal Obstruction; Intestine, Small; Intestines; Physiology; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Antibodies; Chemical Phenomena; Chemistry; Hematinics; Humans; Intrinsic Factor; Vitamin B 12

Topics: Agranulocytosis; Amino Acids; Anemia; Anemia, Pernicious; Antineoplastic Agents; Cortisone; Drug Therapy; Folic Acid; Humans; Iron; Iron-Dextran Complex; Leukemia, Radiation-Induced; Nucleic Acids; Prednisolone; Vitamin B 12; Vitamin B Complex

Topics: Adrenal Cortex Hormones; Anabolic Agents; Anemia; Anemia, Aplastic; Anemia, Hemolytic; Anemia, Hypochromic; Anemia, Pernicious; Humans; Hypersplenism; Iron; Iron-Dextran Complex; Liver Extracts; Steroids; Vitamin B 12; Vitamin B Complex

Topics: Anemia; Anemia, Macrocytic; Blood Platelets; Eosinophilia; Epoetin Alfa; Erythropoietin; Humans; Iron; Leukemia; Polycythemia Vera; Vitamin B 12

Topics: Altitude; Anemia; Anemia, Macrocytic; Anemia, Sickle Cell; Ascorbic Acid; Celiac Disease; Climate; Deficiency Diseases; Female; Folic Acid; Hematology; Humans; Infant; Metabolism; Nutrition Disorders; Parasitic Diseases; Pharmaceutical Preparations; Poisons; Polycythemia; Pregnancy; Pregnancy Complications; Pregnancy Complications, Hematologic; Radiation Effects; Seasons; Sprue, Tropical; Vitamin B 12

Topics: Absorption; Anemia; Anemia, Macrocytic; Biological Assay; Carbon Isotopes; Chromatography; Clinical Enzyme Tests; Clinical Laboratory Techniques; Coenzymes; Corrinoids; Deficiency Diseases; Electrophoresis; FIGLU Test; Folic Acid; Folic Acid Deficiency; Formates; Histidine; Humans; Male; Metabolism; Tritium; Urine; Vitamin B 12

Topics: Adolescent; Anemia; Anemia, Pernicious; Body Fluids; Child; Cobalt Isotopes; Gastric Acidity Determination; Genetics, Medical; Hematinics; Humans; Intestinal Absorption; Intrinsic Factor; Schilling Test; Urine; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Animals; Biological Transport; Cell Membrane Permeability; Cricetinae; Erythrocytes; Gastric Mucosa; Guinea Pigs; Haplorhini; Humans; Intestinal Absorption; Intrinsic Factor; Rats; Research; Vitamin B 12

Topics: Anemia; Anemia, Macrocytic; Coenzymes; Erythropoiesis; Folic Acid; Humans; Metabolism; Research; Vitamin B 12

Topics: Adrenal Insufficiency; Anemia; Anemia, Aplastic; Anemia, Macrocytic; Conjunctivitis; Electrocardiography; Folic Acid; Heart Failure; Hepatitis; Hypertrichosis; Hypopituitarism; Hypothalamus; Leukopenia; Lymph Nodes; Metabolism; Methemoglobinemia; Pharmacology; Phenytoin; Pulmonary Fibrosis; Thrombocytopenia; Thyroid Function Tests; Toxicology; Vitamin B 12

In India, national databases indicate anaemia prevalence of 80 % among 6-35-month-old children and 58 % among 36-59-month-old children. The present study aimed to characterise anaemia and the associated factors among infants and pre-schoolers living in rural India.. Multivariate logistic regression analysis of data collected prior to an intervention trial. Fe-deficiency with anaemia (IDA), Fe deficiency with no anaemia (IDNA) and anaemia without Fe deficiency were defined. Serum ferritin, soluble transferrin receptor (sTfR) and sTfR/log ferritin index were used to indicate Fe status.. Twenty-six villages of Nalgonda district, Telangana, India. Data were collected in community sites. Participants Four hundred and seventy-six infants (aged 6-12 months), 316 pre-schoolers (aged 29-56 months) and their mothers.. Prevalence of anaemia among infants and pre-schoolers was 66·4 and 47·8 %, prevalence of IDA was 52·2 and 42·1 %, prevalence of IDNA was 22·2 and 29·8 %, prevalence of anaemia without Fe deficiency was 14·2 and 5·7 %. Among infants, anaemia was positively associated with maternal anaemia (OR=3·31; 95 % CI 2·10, 5·23; P<0·001), and sTfR/log ferritin index (OR=2·21; 95 % CI 1·39, 3·54; P=0·001). Among pre-schoolers, anaemia was positively associated with maternal anaemia (OR=3·77; 95 % CI 1·94, 7·30; P<0·001), sTfR/log ferritin index (OR=5·29; 95 % CI 2·67, 10·50; P<0·001), high C-reactive protein (OR=4·39; 95 % CI 1·91, 10·06, P<0·001) and young age (29-35 months: OR=1·92; 05 % CI 1·18, 3·13, P=0·009).. Anaemia prevalence continues to be high among infants and pre-schoolers in rural India. Based on sTfR/ferritin index, Fe deficiency is a major factor associated with anaemia. Anaemia is also associated with inflammation among pre-schoolers and with maternal anaemia among infants and pre-schoolers, illustrating the importance of understanding the aetiology of anaemia in designing effective control strategies.

Topics: Anemia; Anemia, Iron-Deficiency; Body Mass Index; Body Weight; C-Reactive Protein; Child, Preschool; Family Characteristics; Female; Ferritins; Folic Acid; Food Supply; Humans; India; Infant; Iron; Iron Deficiencies; Logistic Models; Male; Micronutrients; Morbidity; Multivariate Analysis; Nutrition Assessment; Prevalence; Receptors, Transferrin; Risk Factors; Rural Population; Socioeconomic Factors; Vitamin B 12

Vitamin B12 deficiency may occur with metformin treatment, but few studies have assessed risk with long-term use.. To assess the risk of B12 deficiency with metformin use in the Diabetes Prevention Program (DPP)/DPP Outcomes Study (DPPOS).. Secondary analysis from the DPP/DPPOS. Participants were assigned to the placebo group (PLA) (n = 1082) or the metformin group (MET) (n = 1073) for 3.2 years; subjects in the metformin group received open-label metformin for an additional 9 years.. Twenty-seven study centers in the United States.. DPP eligibility criteria were: elevated fasting glucose, impaired glucose tolerance, and overweight/obesity. The analytic population comprised participants with available stored samples. B12 levels were assessed at 5 years (n = 857, n = 858) and 13 years (n = 756, n = 764) in PLA and MET, respectively.. Metformin 850 mg twice daily vs placebo (DPP), and open-label metformin in the metformin group (DPPOS).. B12 deficiency, anemia, and peripheral neuropathy.. Low B12 (≤ 203 pg/mL) occurred more often in MET than PLA at 5 years (4.3 vs 2.3%; P = .02) but not at 13 years (7.4 vs 5.4%; P = .12). Combined low and borderline-low B12 (≤ 298 pg/mL) was more common in MET at 5 years (19.1 vs 9.5%; P < .01) and 13 years (20.3 vs 15.6%; P = .02). Years of metformin use were associated with increased risk of B12 deficiency (odds ratio, B12 deficiency/year metformin use, 1.13; 95% confidence interval, 1.06–1.20). Anemia prevalence was higher in MET, but did not differ by B12 status. Neuropathy prevalence was higher in MET with low B12 levels.. Long-term use of metformin in DPPOS was associated with biochemical B12 deficiency and anemia. Routine testing of vitamin B12 levels in metformin-treated patients should be considered.

Topics: Adult; Aged; Anemia; Diabetes Mellitus, Type 2; Female; Homocysteine; Humans; Hypoglycemic Agents; Male; Metformin; Middle Aged; Vitamin B 12; Vitamin B 12 Deficiency

Hemoglobin levels slightly below the lower limit of normal are common in adults in the general population in developing countries. A few human studies have suggested the use of antioxidant vitamins in the correction of mild anemia. The objective of the present study was to investigate the association of vitamin E supplementation in mildly anemic healthy adults with post-supplemental blood hemoglobin levels in the general population of Karachi, Pakistan.. In a single-blinded and placebo-controlled randomized trial, 124 mildly anemic subjects from the General Practitioners' Clinics and personnel of the Aga Khan University were randomized into intervention (n = 82) and control (n = 42) group. In the intervention group, each subject was given vitamin E (400 mg) everyday for a period of three months, while control group subjects received a placebo. Eighty six subjects completed the trial. Fasting venous blood was collected at baseline and after three months of supplementation. Hemoglobin levels and serum/plasma concentrations of vitamin E, vitamin B12, folate, ferritin, serum transferrin receptor (sTfR), glucose, total cholesterol, triglycerides, LDL-cholesterol, HDL-cholesterol, creatinine, total-antioxidant-status and erythropoietin were measured and analyzed using repeated measures ANOVA and multiple linear regression.. The adjusted regression coefficients (β) and standard error [SE(β)] of the significant predictors of post-supplemental hemoglobin levels were serum concentration of vitamin E (0.983[0.095]), gender (- 0.656[0.244]), sTfR (- 0.06[0.02]) and baseline hemoglobin levels (0.768[0.077]).. The study showed a positive association between vitamin E supplementation and enhanced hemoglobin levels in mildly anemic adults.

Topics: Adult; Anemia; Antioxidants; Blood Glucose; Dietary Supplements; Erythropoietin; Female; Ferritins; Folic Acid; Hemoglobins; Humans; Lipids; Male; Pakistan; Placebos; Receptors, Transferrin; Sex Factors; Single-Blind Method; Vitamin B 12; Vitamin E

All systems in an organism are affected by protein-energy malnutrition (PEM), but one of the worst affected is the hematopoietic system. Today PEM remains a very serious problem in developing countries. We examined the relationships between clinical features, hematological, and bone marrow changes with severe PEM from Turkey.. We evaluated 34 (11 females and 23 males) consecutive cases of severe PEM, with no underlying diseases aged 3-20 months. The clinical nutritional conditions of the patients were determined using the Wellcome-Trust PEM classification. Ten of the patients were in the Marasmic-Kwashiorkor (M-K) group, 10 were in the Kwashiorkor (KW) group, and 14 were in the Marasmic (M) group. Full blood count, protein, albumin, serum iron (SI), iron-binding capacity (TIBC), ferritin, vitamin B12, folic acid, complement-3 (C3), complement-4 (C4), and bone marrow were investigated in all groups.. Anemia was detected in 97% of patients. We determined serum iron levels were low in 67.6% of the patients, TS levels were low in 76.4% of the patients and ferritin levels were low in 20.5%. The level of vitamin B12 was normal in all patients. Bone marrow analysis showed erythroid series hypoplasia in 28.5% of patients in the M group, 50% in the KW group, and 30% in the M-K group. Marrow iron was absent in 58.8% of patients.. The most common hematologic change in the children with PEM was anemia and major cause of anemia was iron deficiency in this study. Patients with severe PEM have normal Vit B12 and serum folate levels. Most of the patients with severe PEM had normal cellularity with megaloblastic and dysplastic changes in bone marrow due to the inadequate and imbalanced intake of protein and energy.

Topics: Anemia; Blood Proteins; Bone Marrow; Child Nutrition Disorders; Child, Preschool; Female; Folic Acid; Humans; Infant; Infant Nutrition Disorders; Iron; Male; Protein Deficiency; Turkey; Vitamin B 12

The objective of the current analysis was to explore the association of multiple micronutrients with Hb concentration among pregnant women in a South Asian setting, a topic that has not been adequately explored.. Sociodemographic, anthropometric and micronutrient status (plasma ferritin, transferrin receptor, retinol, a- and g-tocopherol, folate, vitamin B12, Zn) and Hb concentration were assessed at early pregnancy.. The biochemical sub-study was nested within a double-blind, placebo-controlled, community-based vitamin A and b-carotene supplementation trial in rural north-western Bangladesh (JiVitA). All assessments were conducted before trial supplementation was initiated.. A systematic sample of 285 women was selected from those enrolled in the biochemical sub-study.. Seventeen per cent of women were mildly anaemic; moderate and severe anaemia was uncommon (2.1 %). a-Tocopherol, vitamin B12 and Zn deficiencies were common (43.5%, 19.7% and 14.7%, respectively); however, vitamin A, folate and Fe deficiencies were comparatively rare (7.4%, 2.8% and ,1%,respectively). Plasma Zn, vitamin B12 and a-tocopherol were positively associated and plasma g-tocopherol was negatively associated with Hb (P < 0.05) after adjustment for gestational age, inflammation status, season and nutritional status measured by mid-upper arm circumference.. Among pregnant women in rural Bangladesh with minimal Fe deficiency, plasma Zn, vitamin B12, and a- and g-tocopherol concentrations were associated with Hb concentration. Appreciating the influence on Hb of micronutrients in addition to those with known associations with anaemia, such as Fe, folate, and vitamin A, is important when addressing anaemia in similar settings.

Topics: Adult; alpha-Tocopherol; Anemia; Bangladesh; Cluster Analysis; Dietary Supplements; Double-Blind Method; Female; Ferritins; gamma-Tocopherol; Hemoglobins; Humans; Iron, Dietary; Micronutrients; Nutritional Status; Pregnancy; Prevalence; Rural Population; Socioeconomic Factors; Surveys and Questionnaires; Vitamin B 12; Women's Health; Young Adult; Zinc

To assess whether addition of cobalamin (cbl) to iron-folic acid will result in improved response in nutritional anemia.. This study included 150 children aged between 0.5-5 y having nutritional anemia. Anemia was categorized for severity and red cell morphology. Serum levels of ferritin were obtained in all cases while levels of cbl and folic acid (FA) were done only in children having macrocytic or dimorphic anemia. Children were randomized to receive either iron and FA (Group I) or iron, FA and cbl (Group II). Response to treatment was assessed at 2, 4 and 8 wk.. Of all the 150 patients, iron deficiency was documented in 111 patients. Of the 41 cases in whom, Cbl and FA levels were done, 97.56% and 53.66% had deficiency of cbl and FA respectively. Patients in group II had higher Hb level at 2, 4 and 8 wk (significant at 4 and 8 wk). Percentage Hb rise from baseline Hb was significantly higher in group II (p 0.00). In group II, increase in Hb among cases with macrocytosis and others were similar although percentage increase in Hb was more pronounced among patients with macrocytic anemia or dimorphic anemia. However, this difference was statistically not significant (p = 0.18).. Children receiving cbl in addition to iron and FA showed an improved hematological response.

Topics: Anemia; Child, Preschool; Enzyme-Linked Immunosorbent Assay; Female; Folic Acid; Hemoglobins; Humans; Infant; Infant Nutrition Disorders; Iron; Male; Prospective Studies; Treatment Outcome; Vitamin B 12

Fortifying rice with multiple micronutrients could be a promising strategy for combat micronutrient deficiencies in developing countries. We determined the efficacy of extruded rice grains fortified with multiple micronutrients on the prevalence of anemia, micronutrient status, and physical and cognitive performance in 6- to 12-y-old, low-income school children in Bangalore, India. In a randomized, double-blind, controlled trial, 258 children were assigned to 1 of 3 intervention groups to receive rice-based lunch meals fortified with multiple micronutrients with either low-iron (6.25 mg) or high-iron (12.5 mg) concentrations or identical meals with unfortified rice. The meals were provided 6 d/wk for 6 mo. Anthropometric, biochemical, physical performance, and cognitive assessments were taken at baseline and endpoint. At baseline, study groups were comparable, with 61% of the children being anemic. However, only <10% were deficient in iron, vitamin A, and zinc. After 6 mo, plasma vitamin B-12 and homocysteine concentrations (both P < 0.001) as well as physical performance (P < 0.05) significantly improved in the intervention arms. No between-group differences were observed in hemoglobin concentration, anemia, and deficiencies of other micronutrients or cognitive function after 6 mo, but paired analyses revealed a small reduction in anemia prevalence in children in the low-iron group. The fortified rice was efficacious in improving vitamin B-12 status and physical performance in Indian school children.

Topics: Anemia; Child; Child Nutrition Disorders; Cognition; Educational Status; Female; Food Services; Food, Fortified; Homocysteine; Humans; India; Iron; Male; Micronutrients; Morbidity; Motor Activity; Oryza; Prevalence; Schools; Vitamin B 12

Clinical observations revealed an increased prevalence of iron deficiency anemia without chronic bleeding in patients treated with serial low-density lipoprotein (LDL) apheresis. Since several different proteins are adsorbed by LDL apheresis beside pro-atherogenic lipoproteins, we examined the modification of the full blood count, plasma iron, vitamin B12, folic acid, and hemolysis by LDL apheresis. Nineteen patients (55 (50-59) years, 4 female, 15 male) undergoing chronic LDL apheresis due to mixed dyslipidemia (N = 17), homozygous familiar hypercholesterolemia (N = 1) or isolated elevated lipoprotein(a) (N = 1) were included in this study. They were treated with direct adsorption of lipoproteins (DALI; N = 6), heparin-induced LDL-precipitation (HELP; N = 7) or double filtration plasmapheresis (DFPP; N = 6). The patients' full blood count, iron metabolism (plasma iron, ferritin, transferrin, transferrin saturation), vitamins involved in erythropoiesis (vitamin B12 and folic acid), and markers of hemolysis (haptoglobin and free hemoglobin) were analyzed directly before and after LDL apheresis. A single LDL apheresis session significantly decreased the levels (reduction in the median [25(th)-75(th) percentiles] of: ferritin 9.8 [1.3-18] %; P = 0.004), transferrin (12.1 [10.0-15.96] %; P = 0.0005), and vitamin B12 (17.8 [16.2-20.8] %; P = 0.0005). Thereby, transferrin and vitamin B12 were decreased in all (N = 19) and ferritin in 74% (N = 14) of the patients. Twelve out of 19 patients (63.2%) had mild anemia despite iron administration in 14 out of 19 patients (73.7%). LDL apheresis had no significant influence on full blood count, plasma iron, transferrin saturation, folic acid, or hemolysis. Similar changes were observed in all LDL apheresis methods used. LDL apheresis significantly decreases ferritin, transferrin, and vitamin B12, suggesting an influence of serial LDL apheresis on erythropoiesis.

Topics: Anemia; Blood Component Removal; Dyslipidemias; Erythropoiesis; Female; Ferritins; Filtration; Heparin; Humans; Hyperlipoproteinemia Type II; Lipoprotein(a); Lipoproteins, LDL; Male; Middle Aged; Plasmapheresis; Transferrin; Vitamin B 12

Methylmalonic aciduria (MMA) is a common one of the congenital disorders of organic acids metabolism. Some of the patients with the disorder are complicated with homocysteinemia. Recently, gas chromatography-mass spectrometry (GCMS) has been used to diagnose MMA in China. However, the diagnosis of the patients with combined MMA and homocysteinemia is often delayed. In this study, the natural history, clinical features and outcome of 57 Chinese patients with combined MMA and homocysteinemia were investigated.. From 1996 to 2006, 96 MMA patients from 16 provinces or cities were diagnosed in our hospital by urine organic acids analysis using GCMS. Homocysteinemia was found by serum and urine total homocysteine determination using a fluorescence polarization immunoassay.. Fifty-seven of the 96 MMA patients (59.4%, 32 males and 25 females) were found to have combined MMA and homocysteinemia. They had markedly increased urine methylmalonic acid, total serum homocysteine (81.5 to 226.5 micromol/L vs. normal range 4.5 to 12.4 micromol/L) and urine homocysteine (79.1 to 414.5 micromol/L vs. normal range 1.0 to 25.0 micromol/L). Thirteen (22.8%) of them presented with symptoms resembled hypoxic-ischemic encephalopathy in the neonatal period. Fourteen (24.6%) patients had the onset at the age of one month to 1 year with mental retardation, vomiting and epilepsy. Nine (15.8%) showed developmental delay, seizures, poor appetite or anemia from the age of 1 to 3 years. Eighteen (31.6%) had psycho-motor degeneration at the age of 6 to 15 years. Among them, 7 patients experienced multiple organ dysfunctions with liver dysfunction, hematuria, renal failure and peripheral neuropathy. Three (5.3%) patients developed progressive mental degeneration, motor disorders and anorexia at the ages of 16, 24 and 34 years. Eleven (19.3%) patients ultimately died; 5 (8.8%) of them were diagnosed postmortem. Forty-six (80.7%) patients were treated with vitamin B12, folic acid, L-carnitine and betaine supplementation and 11 (19.3%) of them recovered completely.. Combined MMA with homocysteinemia is a common form of MMA in China. The clinical spectrum of the patients varies from severe neonatal-onset forms with high mortality to milder forms with adult-onset. Serum or urine total homocysteine analysis is important for the deferential diagnosis of the patients with MMA.

Topics: Adolescent; Adult; Amino Acid Metabolism, Inborn Errors; Anemia; Carnitine; Child; Child, Preschool; China; Female; Gas Chromatography-Mass Spectrometry; Homocysteine; Humans; Male; Metabolic Diseases; Methylmalonic Acid; Urologic Diseases; Vitamin B 12; Vitamin B Complex; Young Adult

We undertook this study to compare the effectiveness and safety of antenatal daily and weekly supplementation with iron, folic acid, and vitamin B(12) in healthy, pregnant women who were not anemic at gestational week 20.. Women with singleton pregnancies and blood hemoglobin (Hb) >115 g/L at gestational week 20 (equivalent to 105 g/L at sea level) were randomly assigned to two groups, one consuming one tablet containing 60 mg iron, 200 mug folic acid and 1 mug vitamin B(12) daily (DS, n = 56); the other consuming two tablets once weekly (WS, n = 60). Blood Hb and serum ferritin concentrations were measured every 4 weeks from weeks 20 to 36, and pregnancy outcomes were evaluated.. Mild anemia and hypoferritinemia throughout pregnancy occurred less frequently in DS than WS. None of the 116 women had Hb concentrations <103 g/L at any evaluation point. In contrast, hemoconcentration (Hb >145 g/L) from gestational week 28 onwards occurred in 11% in DS and 2% in WS. We observed ex post facto that hemoconcentration at gestational week 28 was associated with a significantly higher relative risk of low birth weight (RR 6.23, 95% CI 1.46-26.57) and premature delivery (RR 7.78, 95% CI 1.45-24.74).. In women who were nonanemic at gestational week 20, both schemes (DS and WS) prevented the occurrence of Hb levels <100 g/L. DS women had a higher incidence of hemoconcentration. Hemoconcentration was associated with increased risk of low birth weight and premature delivery.

Topics: Adult; Anemia; Dietary Supplements; Drug-Related Side Effects and Adverse Reactions; Female; Ferritins; Folic Acid; Gestational Age; Hematinics; Hemoglobins; Humans; Infant, Low Birth Weight; Infant, Newborn; Iron; Pregnancy; Pregnancy Complications, Hematologic; Premature Birth; Risk Factors; Vitamin B 12; Vitamin B Complex

The performance of holotranscobalamin (holoTC) was compared with the other markers of vitamin B12 deficiency, and the influence of age, renal function, and thyroid status was examined.. We examined 937 individuals not treated with vitamin B12 but in whom vitamin B12 deficiency was suspected because of a plasma methylmalonic acid (MMA) above 0.28 micromol L(-1) within the past 4 years. Besides laboratory tests, a structured interview and a neurological examination were performed amongst 534 individuals. Amongst these, 140 individuals qualified for a randomized trial (MMA 0.40-2.00 micromol L(-1)). They were randomized to injections with vitamin B12 or placebo and re-examined after 3 months.. One university hospital in Aarhus, Denmark.. The ROC curves indicate that holoTC (AUC: 0.90) compared favourable with plasma vitamin B12 (AUC: 0.85) for identifying individuals likely to have vitamin B12 deficiency (MMA > or =0.75 micromol L(-1) and plasma total homocysteine (tHcy) > or =15 micromol L(-1)), and further that holoTC (AUC: 0.91) might replace combined testing with plasma vitamin B12 and the metabolites. No association was observed between the biochemical markers and symptoms and signs possibly related to vitamin B12 deficiency. HoloTC, TC saturation, plasma vitamin B12, MMA, and tHcy were significantly associated with plasma creatinine (all with P <0.001). Only tHcy was significantly associated with thyroid stimulating hormone (P=0.02).. HoloTC shows promise as first-line tests for diagnosing early vitamin B12 deficiency.

Topics: Adult; Aged; Aged, 80 and over; Anemia; Biomarkers; Creatinine; Female; Homocysteine; Humans; Male; Methylmalonic Acid; Middle Aged; Prognosis; Thyrotropin; Transcobalamins; Vitamin B 12; Vitamin B 12 Deficiency

There is little information on the risk of micronutrient deficiencies during the period of exclusive breast-feeding. We evaluated this among term, low-birthweight (LBW; 1500-2500 g) infants in Honduras. Mother-infant pairs were recruited in the hospital and assisted with exclusive breast-feeding during the first 4 mo. At 4 mo, infants were randomly assigned to either continue exclusive breast-feeding to 6 mo (EBF; n = 59) or be given iron-fortified complementary foods (rice, chicken, fruits, and vegetables) from 4 to 6 mo while continuing to breast-feed (SF, n = 60). Blood samples were collected at 2, 4, and 6 mo and analyzed for hemoglobin (Hb), hematocrit, plasma ferritin, % transferrin saturation, vitamin A, vitamin B-12, folate, zinc, and erythrocyte folate. Infants with Hb < 100 g/L at 2 or 4 mo were given medicinal iron supplements for 2 mo; the proportion administered iron drops did not differ significantly between groups. There was no significant effect of complementary foods on indices of vitamin A, B-12, folate, or zinc status. Among infants not given medicinal iron at 4-6 mo, iron status was higher in the SF group than the EBF group. In those given medicinal iron at 4-6 mo, iron status was higher in the EBF group, suggesting that complementary foods interfered with iron utilization. About half of the infants were anemic by 2 mo, before the age when complementary foods would be recommended. This supports the recommendation that LBW infants should receive iron supplementation in early infancy. Given that infants given iron supplements did not benefit from complementary foods at 4-6 mo, we conclude that exclusive breast-feeding for 6 mo (with iron supplementation) can be recommended for term, LBW infants.

Topics: Anemia; Breast Feeding; Dietary Supplements; Folic Acid; Gestational Age; Honduras; Humans; Infant; Infant Nutritional Physiological Phenomena; Infant, Low Birth Weight; Infant, Newborn; Iron; Minerals; Prenatal Care; Sample Size; Time Factors; Vitamin A; Vitamin B 12; Vitamins; Zinc

The purpose of this article was to determine the prevalence of iron, vitamin B12, and folate deficiency and to evaluate the erythropoietin (EPO) response to anemia in a cohort of long-term intensive care unit (ICU) patients.. All patients admitted to three academic medical center multidisciplinary ICUs were screened for eligibility into a randomized trial of EPO for the treatment of ICU anemia. On their second or third ICU day, patients enrolled in this trial had EPO levels drawn and were screened for iron, B12, and folate deficiency. Weekly EPO levels were obtained throughout patients' ICU stay.. A total of 184 patients were screened for iron, B12, and folate deficiency. Sixteen patients (9%) were iron deficient by study criteria, 4 (2%) were B12 deficient, and 4 (2%) were folate deficient. Mean hemoglobin and reticulocyte percents of the remaining 160 patients were 10.3 +/- 1.2 g/dL and 1.66 +/- 1.09%, respectively. In most patients, serum iron and total iron binding capacity levels were very low, whereas ferritin levels were very high. Mean and median day 2 EPO levels were 35.2 +/- 35.6 mIU/mL and 22.7 mIU/mL, respectively (normal = 4.2-27.8). Serial EPO levels in most persistently anemic patients remained within the normal range.. In this cohort, screening for iron, B12, and folate deficiency identified potentially correctable abnormalities in more than 13% of patients and should be considered in those who are anticipated to have long ICU stays. Even at an early point of critical illness, most patients had iron studies consistent with anemia of chronic disease (ACD), as well as a blunted EPO response that may contribute to this ACD-like anemia of critical illness.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Anemia; APACHE; Cohort Studies; Critical Illness; Deficiency Diseases; Erythropoiesis; Erythropoietin; Female; Folic Acid; Humans; Intensive Care Units; Iron; Iron Deficiencies; Male; Middle Aged; Recombinant Proteins; Vitamin B 12

Impaired uteroplacental perfusion has been shown to play a role in the pathogenesis of some complicated pregnancies with placenta insufficiency. Apart from this, lower oestrogen, magnesium and zinc are found in many of these conditions in the third trimester with placenta insufficiency. In this study, we examined the effect of a 4 mg intravenous dexamethasone injection on estriol, since maternal cortisol or synthetic corticosteroids cross the placental barrier and inhibit the release of dehydroepiandrostesone sulfate in the fetal adrenals. Dexamathasone was found to suppress estriol levels in all groups but a significant difference in suppression was found between the Chemiron--a new combination hematinic--and the control single iron therapy groups. Our preliminary results showed that Chemiron has a protective effect on the development of placenta insufficiency during the third trimester of pregnancy.

Topics: Adult; Anemia; Ascorbic Acid; Dexamethasone; Drug Combinations; Estriol; Female; Ferrous Compounds; Folic Acid; Hematinics; Humans; Magnesium Sulfate; Placental Insufficiency; Pregnancy; Pregnancy Tests; Pregnancy Trimester, Third; Vitamin B 12; Zinc Sulfate

The authors introduce the subject with physiological comments regarding the ability of r-HuEP to stimulate erythropoietic bone marrow, underlining the need for other molecules to backup the therapy (vitamin B12, folic acid and iron). Subsequently, and in the light of this introduction, they outline the indications for r-HuEPO treatment in specialist fields and the relative contraindications. They then report the results obtained in a group of 24 patients with the relevant indications receiving subcutaneous treatment on alterate days with r-HuEPO in fials of 4000 IU/ml. Basal hemoglobin levels were 6-8 g and treatment was continued until levels of around 10-11 g were reached; tolerance was good in both gynecological and obstetric patients.

Topics: Adult; Anemia; Blood Transfusion; Dose-Response Relationship, Drug; Drug Therapy, Combination; Erythropoietin; Female; Ferrous Compounds; Folic Acid; Genital Diseases, Female; Humans; Pregnancy; Puerperal Disorders; Vitamin B 12

A prospective, randomized study was conducted to evaluate the role of vitamin B12 and folinic acid supplementation in preventing zidovudine (ZDV)-induced bone marrow suppression. Seventy-five human immunodeficiency virus (HIV)-infected patients with CD4+ cell counts < 500/mm3 were randomized to receive either ZDV (500 mg daily) alone (group I, n = 38) or in combination with folinic acid (15 mg daily) and intramascular vitamin B12 (1000 micrograms monthly) (group II, n = 37). Finally, 15 patients were excluded from the study (noncompliance 14, death 1); thus, 60 patients (31 in group I and 29 in group II) were eligible for analysis. No significant differences between groups were found at enrollment. During the study, vitamin B12 and folate levels were significantly higher in group II patients; however, no differences in hemoglobin, hematocrit, mean corpuscular volume, and white-cell, neutrophil and platelet counts were observed between groups at 3, 6, 9 and 12 months. Severe hematologic toxicity (neutrophil count < 1000/mm3 and/or hemoglobin < 8 g/dl) occurred in 4 patients assigned to group I and 7 assigned to group II. There was no correlation between vitamin B12 or folate levels and development of myelosuppression. Vitamin B12 and folinic acid supplementation of ZDV therapy does not seem useful in preventing or reducing ZDV-induced myelotoxicity in the overall treated population, although a beneficial effect in certain subgroups of patients cannot be excluded.

Topics: Adult; Anemia; Bone Marrow Diseases; CD4 Lymphocyte Count; Female; Folic Acid; Hematologic Diseases; HIV Infections; Humans; Leucovorin; Male; Neutropenia; Prospective Studies; Vitamin B 12; Zidovudine

One hundred eighty-four premature infants, < 1800 g at birth and < 36 wk gestation, were entered into a study investigating the role of additional folate and vitamin B-12 supplementation of the anemia of prematurity. All patients initially received vitamin E and iron in accordance with accepted standards. Patients were randomly assigned to four groups to receive orally 0.1 mg folate/d for 4 mo, 100 micrograms vitamin B-12 intramuscularly monthly for 4 mo, both supplements, or neither. All other activities including parenteral nutrition were carried out according to established practices, irrespective of study group. By 10-12 wk, infants treated with vitamin B-12 alone or combined with folate had higher hemoglobin values than the untreated (P < 0.0005) or solely folate-treated (P < 0.01) groups. These findings held true irrespective of wide variations in treatment and feeding practices. The only uncontrolled hematologic nutritional factor, selenium, showed a similar pattern of decline for 10-12 wk in all study patients, whether or not they received additional vitamin supplements.

Topics: Anemia; Folic Acid; Glutathione Peroxidase; Hemoglobins; Humans; Infant Nutritional Physiological Phenomena; Infant, Newborn; Infant, Premature; Iron; Nutritional Requirements; Reticulocyte Count; Selenium; Vitamin B 12; Vitamin E

In a prospective randomized study we investigated the potential of subcutaneous recombinant human erythropoietin (rhEpo) as adjuvant treatment for autologous blood transfusions (3 units) in elective surgery. Four and 2 weeks before surgery, 49 patients received 6 x 10,000 U of rhEpo. delta Hb values (days -28 and 0) of the rhEpo group were compared to delta Hb values of 52 controls (no rhEpo). Reticulocytes were measured at days -21, -14, -7 and 0. Peri- and postoperative supplementary homologous blood requirements were compared in the two randomized groups. delta Hb of rhEpo group was 0.96 g/dl (mean value) and 2.38 for controls. Reticulocyte count increased earlier and to higher levels in rhEpo-treated patients. Except in 1 case, Epo was well tolerated. These results indicate that autologous predonation (3 x 400 ml) does not create anemia if adjuvant Epo treatment is given. However, homologous blood requirements were not significantly different, which is probably due to the fact that 96 of the 101 treated patients underwent elective orthopedic surgery requiring limited blood replacement. Significant benefit of the Epo regimen can be expected in elective cardiovascular and hepatic surgery where larger amounts of blood (5-6 units) are needed.

Topics: Adult; Aged; Anemia; Blood Transfusion, Autologous; Erythropoiesis; Erythropoietin; Female; Folic Acid; Humans; Iron; Male; Middle Aged; Orthopedics; Preoperative Care; Prospective Studies; Recombinant Proteins; Vitamin B 12

Topics: Anemia; Clinical Trials as Topic; Drug Therapy, Combination; HIV Infections; Humans; Vitamin B 12; Zidovudine

We conducted a double-blind, placebo-controlled trial of oral azidothymidine (AZT) in 282 patients with the acquired immunodeficiency syndrome (AIDS) or AIDS-related complex. Although significant clinical benefit was documented (N Engl J Med 1987; 317:185-91), serious adverse reactions, particularly bone marrow suppression, were observed. Nausea, myalgia, insomnia, and severe headaches were reported more frequently by recipients of AZT; macrocytosis developed within weeks in most of the AZT group. Anemia with hemoglobin levels below 7.5 g per deciliter developed in 24 percent of AZT recipients and 4 percent of placebo recipients (P less than 0.001). Twenty-one percent of AZT recipients and 4 percent of placebo recipients required multiple red-cell transfusions (P less than 0.001). Neutropenia (less than 500 cells per cubic millimeter) occurred in 16 percent of AZT recipients, as compared with 2 percent of placebo recipients (P less than 0.001). Subjects who entered the study with low CD4 lymphocyte counts, low serum vitamin B12 levels, anemia, or low neutrophil counts were more likely to have hematologic toxic effects. Concurrent use of acetaminophen was also associated with a higher frequency of hematologic toxicity. Although a subset of patients tolerated AZT for an extended period with few toxic effects, the drug should be administered with caution because of its toxicity and the limited experience with it to date.

Topics: Acquired Immunodeficiency Syndrome; Administration, Oral; AIDS-Related Complex; Anemia; Antiviral Agents; Blood Transfusion; Bone Marrow; Clinical Trials as Topic; Double-Blind Method; Erythrocyte Count; Female; Hemoglobins; Humans; Leukocyte Count; Male; Neutropenia; Platelet Count; Random Allocation; Thymidine; Vitamin B 12; Zidovudine

Investigations on 114 anaemic pregnant women revealed that megaloblastosis occurred in more than half. A therapeutic follow-up approach clearly indicated that vitamin B12-deficiency was fairly common in such patients; the need of iron supplementation in many of them for achieving complete remission emphasized the poor status of iron stores. All patients with normoblastic marrow achieved full remission with iron therapy alone. The deficiency of haematinic factors appears to be largely due to poor nutrition.

Topics: Anemia; Anemia, Megaloblastic; Female; Folic Acid; Hemoglobins; Humans; India; Iron; Pregnancy; Pregnancy Complications, Hematologic; Vitamin B 12

Topics: Anemia; Anemia, Hypochromic; Blood Proteins; Clinical Trials as Topic; Deficiency Diseases; Drug Synergism; Female; Folic Acid; Hemoglobins; Humans; Iron; Pregnancy; Pregnancy Complications, Hematologic; Protein Binding; Transferrin; Vitamin B 12

Topics: Anemia; Female; Folic Acid; Hemoglobinometry; Humans; Iron; Pregnancy; Pregnancy Complications, Hematologic; Vitamin B 12

This work reports a portable, origami-type paper device with a plasmonic fluor-labeled microneedle sensing module for the multiplexed quantification of anemia biomarkers in whole blood. Sequential steps, including serum separation, target enrichment, and multiplexed readout by a gel imager, are rapidly accomplished with the flexible and highly integrated device. The microneedle array enabled efficient sampling of trace targets from ng mL

Topics: Anemia; Biomarkers; Folic Acid; Hemoglobins; Humans; Vitamin B 12

Topics: Anemia; Avitaminosis; Humans; Infant; Vitamin B 12; Vitamin B 12 Deficiency

Vitamin D is involved in the pathophysiology of anemia. This cross-sectional study was conducted using the Nationwide Nutrition and Health Survey in Pregnant Women in Taiwan database. We investigated associations among dietary patterns (DPs), vitamin D, and iron-related biomarkers in pregnant women. The principal component analysis revealed four DPs. Linear and logistic regression analyses were performed to investigate the association of DPs with anemia-related biomarkers. Plant-based, carnivore, and dairy and nondairy alternatives DPs were positively associated with serum vitamin D levels. After adjusting covariates, the pregnant women consuming plant-based DPs at the mid-tertile (T2) were associated with reduced risks of low serum folate and vitamin D levels, and those consuming carnivore DPs at higher tertiles (T2 and/or T3) were correlated with an increased risk of low serum iron levels but decreased risks of low serum transferrin saturation, vitamin B

Topics: Anemia; Biomarkers; Cross-Sectional Studies; Female; Folic Acid; Humans; Iron; Pregnancy; Pregnant Women; Taiwan; Vitamin B 12; Vitamin D; Vitamins

Prevalence of vitamin B12 deficiency is occasionally found to be coexisting in patients with hypothyroidism causing persistence of symptoms concomitant to both diseases even on adequate thyroxine supplementation.. A single-centric non-interventional cross sectional study was carried over a period of 1 year. 100 hypothyroid patients were evaluated for prevalence of anemia, and investigated for the etiology. Serum Vitamin B12 was obtained and an association was studied between Vitamin B12 and anti TPO and anti Thyroglobulin antibodies. Here, vitamin B12 deficiency was defined as <160 pg/mL.. Among 100 hypothyroid patients, 31% were males and 69% were females. The mean age of patients was 36.09±12.864 years. 68% patients were found to be Vitamin B12 deficient, and 73.5% of this deficient population were females. 78.6% patients with raised Anti TPO antibodies had vitamin B12 deficiency (p-value = 0.01), while 78% patients with raised Anti Thyroglobulin antibodies were vitamin B12 deficient (p-value = 0.07). The Pearson correlation coefficient (r) was -0.302 (p = 0.002) and -0.253 (p = 0.011) between Vitamin B12 anti anti TPO and anti Thyroglobulin antibodies respectively, thus showing a negative correlation between both.. Thyroid hormones affect erythropoiesis, thus causing anemia in a deficient condition. In iodine sufficient areas, most common cause of hypothyroidism is autoimmune, predisposing individuals to other autoimmune diseases, one being pernicious anemia. In the studied anemic hypothyroid population, Vitamin B12 deficiency was found correlated with raised levels of serum anti-TPO and anti-Thyroglobulin antibodies. Supplementation of B12 may alleviate hypothyroid symptoms, thus making itself a novel addition in the routine hypothyroid prescription. References Aon M, Taha S, Mahfouz K, et al. Vitamin B12 (cobalamin) deficiency in overt and subclinical primary hypothyroidism. Clin Med Insights Endocrinol Diabetes 2022;15:11795514221086634. Ness-Abramof R, Nabriski DA, Shapiro MS, et al. Prevalence and evaluation of B12 deficiency in patients with autoimmune thyroid disease. Am J Med Sci;332(3):119-122.

Topics: Adult; Anemia; Cross-Sectional Studies; Female; Hospitals, Teaching; Humans; Hypothyroidism; Male; Middle Aged; Tertiary Healthcare; Vitamin B 12; Vitamin B 12 Deficiency; Young Adult

Anemia frequently occurs during course of clinical thyroid diseases. Without proper diagnosis & effective treatment of underlying thyroid disease, it is often difficult to achieve complete correction of anemia.. The present study was conducted to assess prevalence & types of anaemia in patients with thyroid disorders.. A cross sectional study was conducted on 160 patients including both hypothyroid & hyperthyroid patients at OPD/IPD in SRN Hospital affiliated to MLN Medical college Prayagraj between July 2021 & August 2022. Blood samples were taken to estimate CBC, GBP with Retic count, S. ferritin, S. folate, S. Vitamin B12, Thyroid profile. Data was entered in MS Excel Spreadsheet & appropriate statistical package applied.. Out of 144 hypothyroid patients, 102 (70.83%) were found to be anaemic & out of 16 hyperthyroid patients, 6 (37.5%) were found to be anaemic. In 102 anaemic hypothyroid patients, 56 (54.9%)had normocytic normochromic, 25 (24.5%) had microcytic and 21 (20.5%) had macrocytic anaemia. In 6 anaemic hyperthyroid patients, 3 (50%) had normocytic normochromic, 2(33.33%) had microcytic and 1 (16.67%) had macrocytic anaemia.. High prevalence of anaemia was found in patients with thyroid disorders. Anaemia is an uncommon finding in hyperthyroidism but when present may be similar to that present in hypothyroidism. The most common type of anaemia in both hyperthyroidism & hypothyroidism was found to be normocytic normochromic, followed by microcytic & least common being macrocytic. References Suhail N, Abu Alsel BT, Batool S. Prevalence and association of thyroid dysfunction with anemia/body iron status among northern border Saudi population. Int J Med Res Health Sci 2020;9(3):1-7. Peraka SA, Karre S, Ravuri S, et al., To evaluate prevalence of anemia in hypothyroid patients. J Diagn Pathol Oncol 2019;4(2):110-113.

Topics: Anemia; Anemia, Macrocytic; Cross-Sectional Studies; Ferritins; Folic Acid; Humans; Hyperthyroidism; Hypothyroidism; Thyroid Diseases; Thyroid Hormones; Vitamin B 12

Roux-en-Y gastric bypass (RYGB) surgery is one of the most commonly performed bariatric procedures for weight loss in humans. However, this procedure is not risk-free, and patients may experience complications that include small bowel obstruction, gastrointestinal bleeding, chronic diarrhea, ulcers, malnutrition, and anemia. In particular, anemia is a recognized long-term complication and can be severe. Rats have been used as a model to study the effects of gastric bypass surgeries. They can experience similar complications as people, but the development of severe anemia has not previously been reported in rats. We observed 2 cases of severe anemia in female Sprague-Dawley rats after RYGB surgery. These cases prompted us to further investigate the frequency and severity of anemia after RYGB in rats. Blood work and necropsies were performed on 9 additional female Sprague-Dawley rats (5 with RYGB, 4 with sham surgery). In these 9 rats, only one had signs of clinical anemia. These 3 anemic rats displayed moderate to severe pallor of the eyes and ears. Necropsy findings in anemic RYGB rats included pale internal organs and eccentric heart enlargement, which led to a significantly higher heart:body weight ratio in RYGB rats as compared with sham controls. Anemic rats had either a macrocytic normochromic anemia, consistent with vitamin B

Topics: Anemia; Animals; Female; Gastric Bypass; Humans; Obesity, Morbid; Rats; Rats, Sprague-Dawley; Vitamin B 12

To evaluate the efficacy and safety of sublingual methylcobalamin for the treatment of vitamin B12 deficiency anemia in children.. A single arm intervention study was conducted between November, 2020 and April, 2022 in children aged 1-12 years with vitamin B12 deficiency anemia. Children aged 1-6 years received a tablet of methylcobalamin (1500 mcg) by sublingual route every alternate day (three doses) while those aged 7-12 years received five such doses. Thereafter, one such sublingual tablet was given weekly and all participants were followed-up for 6 weeks.. 37 children with a mean (SD) age of 8.2 (4.1) years were treated and followed up prospectively. On day 10, no child needed rescue therapy with parenteral methylcobalamin. After 6 weeks, the mean (SD) serum cobalamin (mL) increased from 123.3 (35.5) pg/mL to 507.3 (274.2) pg/mL (P<0.001), plasma homocysteine (L) decreased from 48.9 (17.8) pg/mL to 16.3 (8.5) µmol/L (P<0.001), the mean (SD) hemoglobin increased by 2.3 (1.1) g/dL (P<0.001), and MCV decreased by 12.9 (6.8) fL (P<0.001). 67.6% children persisted to have anemia, albeit majority of them had mild or moderate anemia. There were no unsolicited side-effect reported.. Sublingual methylcobalamin is effective for the treatment of vitamin B12 deficiency anemia in children; although, the duration of treatment needs to be longer than six weeks.

Topics: Anemia; Child; Gastrointestinal Diseases; Humans; Tablets; Vitamin B 12; Vitamin B 12 Deficiency

Anemia-causing fever has been described in patients with megaloblastic anemia. Although the exact mechanism of this is unknown, high-grade fever is relatively less reported.. This prospective observational study included all new cases of megaloblastic anemia presenting with febrile illness (>101°F) during a 3-year period. Patients with existing anemia, comorbidities, and other causes of macrocytosis were excluded. A detailed evaluation for megaloblastic anemia and workup for excluding tropical infections was done. The patients were treated with parenteral vitamin B12, folic acid, and other hematinics.. Around 24 cases of megaloblastic anemia presenting with high-grade fever were included, with 14 (58.3%) males, mean duration of fever 7.7 days (4-18 days), and 09 (37.5%) having temperature >103°F. The mean hemoglobin (Hb) was 8.15 g/dL (3.7-11.1 g/dL), the mean corpuscular volume (MCV) was 111 ± 7.8 fL, 18 (75%) had unconjugated hyperbilirubinemia, the mean lactate dehydrogenase (LDH) was 814 ± 24 IU/L, and 21 (87.5%) had low B12 or folate levels. Most showed good therapeutic response to B12 or folic acid with defervescence in 1-5 days (mean 2.6 days) and improvement in lab parameters in 1 week. The study population was divided into those with temperature ≥103°F, and temperature <103°F it was seen that there was a significant association (p < 0.05) with leucocyte count of ≤3000/cumm, and MCV ≥110 fL, in patients with temperature ≥103°F Conclusion: Megaloblastic anemia should be considered in the differentials of a patient presenting with a febrile illness with no clinical localization and a negative initial fever workup. Early identification and prompt therapy of this easily treatable disorder are very essential.

Topics: Anemia; Anemia, Megaloblastic; Female; Folic Acid; Folic Acid Deficiency; Humans; Male; Vitamin B 12; Vitamin B 12 Deficiency

Anemia is the most common dose-limiting toxicity of olaparib. However, few studies have analyzed the clinical features of olaparib-induced anemia. This study investigated the clinical features of olaparib-induced anemia. Additionally, the role of folate or vitamin B12 in olaparib-induced anemia was examined. This retrospective case-control study included patients who received olaparib at Mie University Hospital between January 2018 and December 2020. Data were collected between initiation of olaparib and discontinuation of olaparib or till December 2021. We investigated the development of grade ≥ 3 anemia during olaparib administration for at least 1 year. We examined patients with grade ≥ 3 anemia considering the mean corpuscular volume (MCV), its association with gastrointestinal events and cumulative dose of carboplatin. For the sub-study analysis, data on patients treated with olaparib for ovarian or endometrial cancer were collected to evaluate the Common Terminology Criteria for Adverse Events (CTCAE) or monthly changes in folate or vitamin B12 levels from baseline to 3 months after olaparib initiation. These data were collected between initiation of olaparib and discontinuation of olaparib or till November 2022. Patients with no data on folic acid or vitamin B12 levels were excluded from the sub-study. In the main study, 40 patients were included. Eighteen patients (45%) developed grade ≥ 3 anemia, and all patients discontinued treatment (94%) or reduced olaparib dose (67%) after developing anemia. Among the patients with grade ≥ 3 anemia, 9 (50%) exhibited macrocytic anemia and 15 (83%) had previously received carboplatin. The incidence of grade ≥ 2 dysgeusia was significantly higher in patients with grade ≥ 3 anemia (P = .034). Moreover, the cumulative dose of previously administered carboplatin was higher in patients who had 3 episodes of anemia (P = .102). In sub-study, 12 had data on folic acid and vitamin B12 levels. Sub-study analysis showed that none fulfilled the criteria for deficiency of folate or vitamin B12, while 3 developed grade 3 anemia. This study revealed that olaparib-induced anemia frequently occurs as macrocytic and normocytic erythroblastic anemia without folate or vitamin B12 deficiencies. A high cumulative dose of previously administered carboplatin and dysgeusia may be associated with olaparib-induced anemia.

Topics: Anemia; Carboplatin; Case-Control Studies; Dysgeusia; Folic Acid; Folic Acid Deficiency; Hemoglobins; Humans; Retrospective Studies; Vitamin B 12; Vitamin B 12 Deficiency

BACKGROUND Surgical management in patients who undergo traumatic blood loss but who refuse blood transfusion can be challenging, but physicians and surgeons must comply with the wishes and beliefs of their patients. This report describes the management of severe anemia, with hemoglobin level of 2.5 g/dL, in a 71-year-old male Korean trauma patient who declined blood transfusion. CASE REPORT A 71-year-old man was admitted to hospital with severe blood loss following trauma. He declined blood transfusion due to his religious belief as a Jehovah's Witness. On day 4, the patient's hemoglobin level dropped from 7.7 to 3.9 g/dL. Despite the need for blood transfusion, the patient refused. Hence, therapeutic strategies, including crystalloid fluid resuscitation, bleeding control, vasopressor support, erythropoietin administration, supplementation with iron, folic acid, and vitamin B12, coagulopathy correction, oxygen consumption reduction, and mechanical ventilation were implemented. Following 16 days of supportive management, the hemoglobin reached 7.4 g/dL. However, it suddenly decreased on day 41 (2.5 g/dL) due to episodes of melena secondary to an actively bleeding gastric ulcer, which was successfully managed with endoscopic hemostasis. Despite increased vasopressor dosage and addition of vasopressin and hydrocortisone, the patient became unresponsive with persistent hypotension. Methylene blue was used as the final therapeutic agent. The patient responded well and subsequently recovered without blood transfusion. CONCLUSIONS This report has presented the clinical challenges of managing the case of a patient who requires but declines blood transfusion and has highlighted the approach to clinical care while respecting the wishes of the patient.

Topics: Aged; Anemia; Blood Transfusion; Hemoglobins; Humans; Jehovah's Witnesses; Male; Vitamin B 12

Hematinic deficiency irrespective of anemia is not uncommon in patients with heart failure. We studied the prevalence, distribution, and etiology of anemia in patients with heart failure with reduced ejection fraction (HFrEF) and compared it with non-anemic patients.. Congestive heart failure (CHF) was diagnosed by modified Framingham criteria and ejection fraction (EF) <40%. Iron deficiency (ID) anemia was defined as serum ferritin level <100 ng/ml (absolute) or 100-300 ng/ml with transferrin saturation <20% (functional). Vitamin B12 and folate deficiency were defined as <200pg/ml and <4ng/ml respectively.. 688 patients with HFrEF were studied with an overall mean age of 57.2±13.8 years, and males outnumbering females (62.3% vs. 37.7%). Coronary artery disease (44.2%), dilated cardiomyopathy (46.8%), and valvular heart disease (6.7%) were major causes of CHF.Anemia was found in 63.9% of patients. Vit B12 deficiency, and folate deficiency were found in 107 (15.55%), and 54 (7.85%) subjects, respectively. Absolute ID was detected in 186 (42.27%) patients with anemia and 84 (33.87%) patients without anemia, while functional ID was present in 80 (18.18%) patients with anemia and 29 (11.69%) patients without anemia. Vitamin B12 deficiency was noted in 70 (15.9%) patients with anemia and 37 (14.9%) patients without anemia, while folate deficiency was noted in 31 (7.04%) patients with anemia and 23 (9.2%) patients without anemia. Hematinic deficiency among the study population was distributed equally among patients irrespective of EF, NYHA class, socioeconomic class diet pattern.. The study shows that hematinic deficiency was seen even in non-anemic patients irrespective of diet pattern. Supplementation could be a strong strategy to improve outcomes in these patients of heart failure irrespective of anemia and should be evaluated in prospective studies.

Topics: Adult; Aged; Anemia; Anemia, Iron-Deficiency; Female; Folic Acid; Heart Failure; Hematinics; Humans; Male; Middle Aged; Prospective Studies; Stroke Volume; Ventricular Dysfunction, Left; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Anemia; Anemia, Iron-Deficiency; Ascorbic Acid Deficiency; Humans; Scurvy; Vitamin B 12; Vitamin B 12 Deficiency

Vitamin B12 deficiency is not an independent risk factor for cardiovascular disease. However, anemia due to vitamin B12 deficiency and also hyperhomocysteinemia are among the cardiovascular risk factors. The study aimed to determine the frequency of vitamin B12 deficiency in patients with acute coronary syndrome. We also aimed to ascertain whether there is a significant difference between obstructive coronary artery disease presence and its severity in patients with and without vitamin B12 deficiency using the Gensini score.. Patients who underwent coronary angiography due to acute coronary syndrome between June 1, 2018, and November 30, 2019, and whose vitamin B12 levels were measured were retrospectively analyzed. Coronary angiography results of the patients were evaluated with the Gensini scoring system.. Anemia was observed in 32.6% (n = 135) of the patients who underwent coronary angiography with a diagnosis of acute coronary syndrome, and vitamin B12 deficiency was observed in 14.7% (n = 61). The median age was 69 years in anemic patients and 68 years in those with Vitamin B12 deficiency and was significantly higher than patients without anemia and vitamin B12 deficiency (p < 0.001 and p = 0.038, respectively). There was no statistically significant differences between the patients' Gensini scores with or without Vitamin B12 deficiency (p = 0.554).. We concluded that anemia and vitamin B12 deficiency were higher in elderly patients with acute coronary syndrome. We found no significant difference when the Gensini score was used to evaluate obstructive coronary artery disease presence and its severity according to anemia and vitamin B12 deficiency. Investigating vitamin B12 levels in elderly patients with acute coronary syndrome should not be ignored.

Topics: Acute Coronary Syndrome; Aged; Anemia; Humans; Hyperhomocysteinemia; Retrospective Studies; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Adolescent; Anemia; Anemia, Iron-Deficiency; Biomarkers; C-Reactive Protein; Celiac Disease; Child; Erythropoietin; Female; Ferritins; Folic Acid; Hemoglobins; Hepcidins; Humans; Infections; Inflammatory Bowel Diseases; Iron; Male; Receptors, Transferrin; Transferrin; Vitamin B 12

Anemia in children is a significant public health problem in our country. Comprehensive National Nutrition Survey 2016-18 provides evidence that more than 50% of childhood anemia is due to an underlying nutritional deficiency. The National Family Health Survey-5 has reported an increase in the prevalence of anemia in the under-five age group from 59% to 67.1% over the last 5 years. Clearly, the existing public health programs to decrease the prevalence of anemia have not shown the desired results. Hence, there is a need to develop nationally acceptable guidelines for the diagnosis, treatment and prevention of nutritional anemia.. To review the available literature and collate evidence-based observations to formulate guidelines for diagnosis, treatment and prevention of nutritional anemia in children.. These guidelines have been developed by the experts from the Pediatric Hematology-Oncology Chapter and the Pediatric and Adolescent Nutrition (PAN) Society of the Indian Academy of Pediatrics (IAP). Key areas were identified as: epidemiology, nomenclature and definitions, etiology and diagnosis of iron deficiency anemia (IDA), treatment of IDA, etiology and diagnosis of vitamin B12 and/or folic acid deficiency, treatment of vitamin B12 and/or folic acid deficiency anemia and prevention of nutritional anemia. Each of these key areas were reviewed by at least 2 to 3 experts. Four virtual meetings were held in November, 2021 and all the key issues were deliberated upon. Based on review and inputs received during meetings, draft recommendations were prepared. After this, a writing group was constituted which prepared the draft guidelines. The draft was circulated and approved by all the expert group members.. We recommend use of World Health Organization (WHO) cut-off hemoglobin levels to define anemia in children and adolescents. Most cases suspected to have IDA can be started on treatment based on a compatible history, physical examination and hemogram report. Serum ferritin assay is recommended for the confirmation of the diagnosis of IDA. Most cases of IDA can be managed with oral iron therapy using 2-3 mg/kg elemental iron daily. The presence of macro-ovalocytes and hypersegmented neutrophils, along with an elevated mean corpuscular volume (MCV), should raise the suspicion of underlying vitamin B12 (cobalamin) or folic acid deficiency. Estimation of serum vitamin B12 and folate level are advisable in children with macrocytic anemia prior to starting treatment. When serum vitamin B12 and folate levels are unavailable, patients should be treated using both drugs. Vitamin B12 should preferably be started 10-14 days ahead of oral folic acid to avoid precipitating neurological symptoms. Children with macrocytic anemia in whom a quick response to treatment is required, such as those with pancytopenia, severe anemia, developmental delay and infantile tremor syndrome, should be managed using parenteral vitamin B12. Children with vitamin B12 deficiency having mild or moderate anemia may be managed using oral vitamin B12 preparations. After completing therapy for nutritional anemia, all infants and children should be advised to continue prophylactic iron-folic acid (IFA) supplementation as prescribed under Anemia Mukt Bharat guidelines. For prevention of anemia, in addition to age-appropriate IFA prophylaxis, routine screening of infants for anemia at 9 months during immunization visit is recommended.

Topics: Adolescent; Anemia; Anemia, Iron-Deficiency; Anemia, Macrocytic; Child; Child, Preschool; Ferritins; Folic Acid; Folic Acid Deficiency; Hematology; Hemoglobins; Humans; Infant; Iron; Vitamin B 12; Vitamin B 12 Deficiency

Existing studies have reported the significant association between atrophic glossitis (AG) and hematinic deficiencies, including iron, folate and vitamin B12 deficiency. However, these findings were inconsistent. AG can be graded as partial or complete atrophy. It is still unclear whether hematinic deficiencies are associated with the grading of AG.. 236 AG patients and 208 sex- and age-matched healthy controls were enrolled in this study. Hematological tests including complete blood count, and serum levels of folate, ferritin and vitamin B12 were performed. The AG group was divided into those with partial AG and those with complete AG according to the extent of papillary atrophy. Statistical analysis was performed to assess whether hematinic deficiencies are risk factors for AG and its grading.. Compared with the healthy controls, AG patients had significantly higher frequencies of vitamin B12 deficiency (68.22%), ferritin deficiency (13.98%) and anemia (21.61%). The differences in hematinic deficiencies and anemia between AG patients and healthy controls changed according to gender and age. The frequencies of serum vitamin B12 deficiency and anemia in the complete AG subgroup were significantly higher than those in the partial AG subgroup. Logistic regression analysis revealed that vitamin B12 deficiency and anemia were significantly correlated with AG and its grading. The AG patients with vitamin B12 deficiency responded well to supplement therapy.. AG could be an important clinical indicator for potential vitamin B12 deficiency, especially when the degree of tongue atrophy more than 50% and complete atrophy. Vitamin B12 deficiency might play an etiological role in the development of AG.

Topics: Anemia; Atrophy; Autoantibodies; Case-Control Studies; Erythrocyte Indices; Ferritins; Folic Acid; Glossitis; Hematinics; Hemoglobins; Humans; Hyperhomocysteinemia; Parietal Cells, Gastric; Tongue; Vitamin B 12; Vitamin B 12 Deficiency

To evaluate the influence of an algorithm designed to incorporate reflex testing according to haemogram results for analytical tests ordered to investigate anaemia.. In 2020, a new request for 'initial study of anaemia' was created in three primary care pilot centres for suspected anaemia or new anaemias. A haemogram was ordered and the remainder of the tests were created in a reflex manner according to an algorithm integrated in the laboratory information system that also generates a comment that is completed and validated by a haematologist. The demand for tests was evaluated over three time periods.. Of 396 requests, anaemia was detected in 80 (20.2%), with 26 microcytic anaemias (6.57%), 20 iron deficiency anaemias, 41 (10.3%) normocytic anaemias and 13 macrocytic anaemias (3.28%); 4 with folate deficiency; and 1 haemolytic anaemia. No haematological diseases were detected. Twenty-four (6.06%) cases exhibited microcytosis/hypochromia without anaemia, 12 of which exhibited iron deficiency. Four young women exhibiting within-limit haemoglobin levels had iron deficiency. There were 56 (14.1%) cases of macrocytosis without anaemia.With the new profile of 'initial study of anaemia', the demand for tests was reduced and was significantly lower than in the remainder of primary centres for iron, transferrin, ferritin, vitamin B. A new profile of 'initial study of anaemia' in the request form with algorithms integrated in the laboratory information system enabled submission of orders and decreased the demand for unnecessary iron, transferrin, ferritin, vitamin B

Topics: Algorithms; Anemia; Automation, Laboratory; Biomarkers; Blood Chemical Analysis; Clinical Laboratory Information Systems; Decision Support Techniques; Ferritins; Folic Acid; Hemoglobins; Humans; Iron; Pilot Projects; Predictive Value of Tests; Primary Health Care; Transferrin; Unnecessary Procedures; Vitamin B 12

Women living with HIV (WLHIV) have a higher prevalence of anemia than women without HIV, possibly related to the effects of HIV and antiretroviral medications.. To estimate the prevalence of anemia in the third trimester of pregnancy and the effect of anemia on preterm births in WLHIV in the longitudinal, US-based Pediatric HIV/AIDS Cohort Study (PHACS).. During the third trimester, we obtained up to three 24-hour dietary recalls to estimate daily intakes of nutrients and measured serum concentrations of iron, vitamin B6, vitamin B12, zinc, folate, ferritin, total iron-binding capacity (TIBC), and high sensitivity C-reactive protein. Third trimester anemia was defined as hemoglobin < 11 g/d and iron-deficiency anemia (IDA) was defined as low ferritin, high TIBC, and low transferrin saturation. A preterm birth was defined as birth at < 37 completed weeks of gestation, regardless of etiology. We fit separate modified Poisson regression models for each outcome (anemia, preterm birth) and each main exposure, adjusted for confounders, and report adjusted prevalence ratios (aPR) and 95% CIs.. Of the 267 WLHIV, 50% were anemic in the third trimester, of whom 43.5% (n = 57/131) had IDA. On average, women with anemia were younger, were more likely to be black, started antiretroviral medications in the second trimester, had a low CD4 count (<200 cells/mm3) early in pregnancy, and were less likely to meet recommended intakes for iron, B6, and folate. The prevalence of anemia was greater in WLHIV with a low CD4 count (aPR = 1.65; 95% CI: 1.20-2.27) and high HIV viral load (>10,000 copies/mL; aPR = 1.38; 95% CI: 1.02-1.87). In total, 16% of women delivered preterm. Anemia was associated with a 2-fold (aPR = 2.04; 95% CI: 1.12-3.71) higher prevalence of preterm births.. Anemia is common in pregnant WLHIV, highlighting the need to address the underlying factors and clinical outcomes of anemia in this population.

Topics: Adult; Anemia; Anemia, Iron-Deficiency; C-Reactive Protein; Female; Ferritins; Folic Acid; HIV; HIV Infections; Humans; Infant, Newborn; Iron; Iron-Binding Proteins; Longitudinal Studies; Pregnancy; Pregnancy Complications; Pregnancy Complications, Infectious; Pregnancy Trimester, Third; Premature Birth; Prevalence; United States; Vitamin B 12; Vitamin B 6; Zinc

Our previous study found the serum gastric parietal cell antibody (GPCA) positivity in 12.3% of burning mouth syndrome (BMS) patients. This study assessed whether GPCA-positive BMS (GPCA. The mean corpuscular volume, blood hemoglobin (Hb), and serum iron, vitamin B12, folic acid, homocysteine, and GPCA levels were measured and compared between any two of three groups of 109 GPCA. We found that 109 GPCA. GPCA

Topics: Anemia; Burning Mouth Syndrome; Folic Acid; Folic Acid Deficiency; Glossitis; Hematinics; Hemoglobins; Humans; Hyperhomocysteinemia; Iron; Parietal Cells, Gastric; Vitamin B 12; Vitamin B 12 Deficiency

Hidden hunger is widespread in India. Individual dietary diversity score (IDDS) is a measure of the nutrient adequacy of the diet. The FAO has set guidelines for the measurement of dietary diversity: the IDDS and the minimum dietary diversity score for women (MDD-W) to assess nutritional deficiency, but validation against nutritional biomarkers is required. Using available data among rural youth (17 years) from the Pune Maternal Nutrition Study, the validity of DDS was assessed to measure deficiencies of vitamin B12, folate and Hb. Of the 355 boys and 305 girls, 19 % were classified as underweight, 57 % as vitamin B12 deficient (<150 pmol/l) and 22 % as anaemic (<120/130 g/l). Cereals, legumes and 'other-vegetables' were the most frequently consumed foods. More boys than girls consumed milk, flesh, eggs and micronutrient-dense foods. Median IDDS of 4 (interquartile range (IQR) 3-4) and MDD-W of 6 (IQR 5-7) were low. Youth with vitamin B12 deficiency had a higher likelihood of an IDDS ≤ 4 (1·89; 95 % CI 1·24, 2·87) or an MDD-W ≤ 5 (1·40; 95 % CI 1·02, 1·94). Youth with anaemia were more likely to have an IDDS ≤ 4 (1·76; 95 % CI 1·01, 3·14) adjusted for socio-economic scores, BMI, energy intake and sex. Folate deficiency was low (3 %) and was not associated with either score. Youth with lowest plasma vitamin B12 and Hb infrequently or never consumed dairy products/non-vegetarian foods. These rural Indian youth were underweight, had low DDS and consumed foods low in good-quality proteins and micronutrients. Associations of DDS with circulating micronutrients indicate that DDS is a valid measure to predict vitamin B12 deficiency and anaemia.

Topics: Adolescent; Anemia; Biomarkers; Diet; Female; Folic Acid; Hemoglobins; Humans; India; Male; Micronutrients; Nutritional Status; Thinness; Vegetables; Vitamin B 12; Vitamin B 12 Deficiency; Vitamins

Topics: Aged; Anemia; Erythrocyte Volume; Erythrocytes, Abnormal; Female; Ferric Compounds; Gastrointestinal Hemorrhage; Hemoglobins; Hemorrhoids; Humans; Infusions, Intravenous; Leucovorin; Maltose; Rectum; Reticulocyte Count; Vitamin B 12

This study aimed to investigate the efficacy of enteral supplementation of vitamin B12 for vitamin B12 deficiency in patients who underwent total gastrectomy for gastric cancer.. The study enrolled 133 patients who underwent total gastrectomy for gastric cancer at Kochi Medical School. Clinical data were obtained to investigate associations between vitamin B12 supplementation and vitamin B12 levels. Vitamin B12 deficiency was defined as serum vitamin B12 less than 200 pg/mL. Baseline characteristics and changes in hematological variables, including vitamin B12 levels, were examined.. Vitamin B12 deficiency was present in 71.4% of the 133 patients. Vitamin B12 levels at 3, 6, and 12 months after enteral supplementation were 306 pg/mL, 294 pg/mL, and 367 pg/mL, respectively, which were all significantly higher than those before supplementation (p < 0.001 for all comparisons). The median red blood cell count at 3, 6, and 12 months after enteral supplementation were 380 × 104/mm3, 394 × 104/mm3, and 395 × 104/mm3, respectively, which were all significantly higher than those before supplementation (p = 0.020, p = 0.001, and p = 0.003, respectively). Vitamin B12 levels at 3, 6, and 12 months after supplementation were significantly higher in patients supplemented enterally than those supplemented parenterally (p < 0.001 for all comparisons).. Vitamin B12 deficiency was found in 71.4% of postoperative patients who underwent total gastrectomy for gastric cancer, and enteral vitamin B12 supplements might be effective to improve anemia in these patients.

Topics: Adult; Aged; Aged, 80 and over; Anemia; Dietary Supplements; Enteral Nutrition; Female; Gastrectomy; Humans; Male; Middle Aged; Postoperative Period; Retrospective Studies; Stomach Neoplasms; Treatment Outcome; Vitamin B 12; Vitamin B 12 Deficiency

Lacto-vegetarians (LVs) tend to have vitamin B12 deficiency (B12D). This study assessed whether 140 female LVs, including 16 B12D/LVs and 124 non-B12D/LVs, had significantly higher frequencies of microcytosis, macrocytosis, and of blood hemoglobin (Hb), red blood cell (RBC), and serum vitamin B12 deficiencies than 140 healthy control subjects (HCSs).. The complete blood count and serum vitamin B12 level in 140 female LVs and 140 female HCSs were measured and compared.. We found that 8.6%, 4.3%, 22.9%, 20.0%, and 11.4% of 140 LVs had microcytosis, macrocytosis, and blood Hb, RBC, and serum vitamin B12 deficiencies, respectively. The 140 LVs, 16 B12D/LVs, and 124 non-B12D/LVs had significantly higher frequencies of microcytosis as well as blood Hb and RBC deficiencies than 140 HCSs (all P-values < 0.005). Moreover, both 140 LVs and 124 non-B12D/LVs had significantly higher frequencies of macrocytosis than 140 HCSs. In this study, 32 (22.9%) of 140 LVs including 5 B12D/LVs and 27 non-B12D/LVs had anemia. Of the 5 anemic B12D/LVs, three had normocytic anemia, one had iron deficiency anemia (IDA), and one had thalassemia trait-induced anemia. Moreover, of the 27 anemic non-B12D/LVs, 18 had normocytic anemia, one had IDA, one had thalassemia trait-induced anemia, and 7 had microcytic anemia other than IDA and thalassemia trait-induced anemia.. LVs have significantly higher frequencies of microcytosis, macrocytosis, blood Hb, RBC, and serum vitamin B12 deficiencies than HCSs. Normocytic and microcytic anemias are the two most common types of anemia in our LVs.

Topics: Anemia; Anemia, Iron-Deficiency; Autoantibodies; Erythrocyte Indices; Female; Folic Acid; Hemoglobins; Humans; Hyperhomocysteinemia; Iron; Parietal Cells, Gastric; Vegetarians; Vitamin B 12; Vitamin B 12 Deficiency

To describe the current status of micronutrient deficiencies (MD) and anemia in Mexican children.. Serum data from 1 382 pre-school-age chil-dren (1-4 years) and 3 590 school-age children (5-11 years) Ensanut 2018-19 participants were analyzed. Iron deficiency (ID), vitamin B12 deficiency (B12D), vitamin A depletion (VADp), and anemia were identified. Logistic regression models were used to identify associations between socio-demographic characteristics of children and MD.. Anemia was present in 28.9 and 19.2% of the children aged 1-4 and 5-11, respectively; in ID 10 and 5.1%; B12D, in 5.1 and 4.8%, and VADp, in 4.7 and 4.3%. 18.5% of the preschool-age children and 13% of the school-age children had at least one MD associated to anemia.. MD and anemia affect the younger children in larger proportion. Fortification and supplementation programs should be reinforced to avoid the long-term consequences of MD.

Topics: Anemia; Child; Child, Preschool; Humans; Infant; Iron; Mexico; Nutritional Status; Vitamin A; Vitamin B 12

Research to date suggests that nickel affects not only the metabolism of vitamin B12 but also folates and thus may affect hematopoiesis processes.. The aim of the study was to examine the relationship of nickel (Ni) status to red blood cell (RBC) parameters and serum vitamin B12, folate and homocysteine concentrations in the course of normal pregnancy and in pregnant women with anemia.. The study included fifty-three pregnant women recruited to the study from the Lower Silesia region of Poland, 17 % of whom developed anemia. Nickel concentration was determined in urine, whole blood and food samples by atomic absorption spectrometry. At the same time as the food and urine samples were taken, blood was also collected for the determination of RBC parameters and serum vitamin B12, homocysteine and folate concentrations.. The median reported Ni intake, and the urinary and whole blood nickel contents for the studied pregnant women for the first trimester were respectively - 162.46 μg/day, 3.98 μg/L and 3.32 μg/L; for the second trimester - 110.48 μg/day, 6.86 μg/L and 1.04 μg/L; and for the third trimester - 132.20 μg/day, 3.41 μg/L and 0.70 μg/L. With regard to Ni concentration in whole blood (p = 0.0204) and in urine (p = 0.0003), the differences in the values for individual trimesters were statistically significant. The whole blood Ni level was significantly higher (9.28 vs 3.62 μg/L, p = 0.0114), while the concentration of homosysteine was significantly lower (4.09 vs 5.04 μmol/L, p = 0.0165) in pregnant women with anemia compared to those without anemia. The whole blood Ni concentration was negatively correlated with almost all RBC parameters in non-anemic pregnant women.. Ni status changes with the development of normal pregnancy, and in the case of anemia, an increase in Ni concentration in whole blood is observed. The demonstrated correlations between the Ni status in pregnant women and RBC parameters as well as serum vitamin B12 and folate concentrations suggest that nickel is associated with the methionine-folate cycle, iron homeostasis and bacterial synthesis of vitamin B12 in humans.

Topics: Anemia; Erythrocytes; Female; Folic Acid; Homocysteine; Humans; Nickel; Pregnancy; Vitamin B 12

Testing and prescribing vitamin B12 (also known as cobalamin) is increasing in Switzerland but substantial variation among general practitioners (GPs) with respect to testing has been noted. In this study, we aimed at exploring GPs' mindsets regarding vitamin B12 testing and prescribing. A cross-sectional study was conducted using an online survey distributed by e-mail to Swiss GPs. The questionnaire explored mindsets related to testing and prescribing vitamin B12 in specific clinical situations, as well as testing and prescribing strategies. The questionnaire was sent to 876 GPs and 390 GPs responded (44.5%). The most controversial domains for testing and prescribing vitamin B12 were idiopathic fatigue (57.4% and 43.4% of GPs agreed, respectively) and depressive symptoms (53.0% and 35.4% of GPs agreed, respectively). There was substantial variation among GPs with regard to testing strategies (89.5% of GPS used a serum cobalamin test, 71.3% of GPS used holotranscobalamin, and 27.6% of GPs used homocysteine or methylmalonic acid). Intramuscular injection was the predominantly prescribed route of application (median of 87.5% of the prescriptions). In this study, we focus on discordant mindsets that can be specifically targeted by using educational interventions, and research questions that still need answering specifically about the effectiveness of vitamin B12 for idiopathic fatigue.

Topics: Adolescent; Adult; Anemia; Attitude of Health Personnel; Clinical Laboratory Techniques; Cross-Sectional Studies; Depression; Fatigue; Female; General Practice; General Practitioners; Humans; Male; Physicians; Polyneuropathies; Practice Patterns, Physicians'; Surveys and Questionnaires; Switzerland; Vitamin B 12; Vitamin B 12 Deficiency; Young Adult

Our previous study found that 127 of 1064 atrophic glossitis (AG) patients have hyperhomocysteinemia. This study assessed whether the AG patients with hyperhomocysteinemia had significantly higher frequencies of anemia, hematinic deficiencies, and serum gastric parietal cell antibody (GPCA) positivity than AG patients without hyperhomocysteinemia or healthy control subjects.. The blood hemoglobin (Hb) and serum iron, vitamin B12, folic acid, homocysteine, and GPCA levels in 127 AG patients with hyperhomocysteinemia, 937 AG patients without hyperhomocysteinemia, and 532 healthy control subjects were measured and compared.. We found that 127 AG patients with hyperhomocysteinemia had significantly higher frequencies of blood Hb and serum iron, vitamin B12, and folic acid deficiencies and serum GPCA positivity than 532 healthy control subjects (all P-values < 0.001) and significantly higher frequencies of blood Hb and serum vitamin B12 and folic acid deficiencies and serum GPCA positivity than 937 AG patients without hyperhomocysteinemia (all P-values < 0.001). Moreover, 127 AG patients with hyperhomocysteinemia had significantly higher frequencies of macrocytic anemia and significantly lower frequencies of normocytic anemia than 937 AG patients without hyperhomocysteinemia (both P-values < 0.001). Pernicious anemia (22 cases) was found only in AG patients with hyperhomocysteinemia but not in AG patients without hyperhomocysteinemia.. AG patients with hyperhomocysteinemia had significantly higher frequencies of anemia, serum iron, vitamin B12, and folic acid deficiencies, and serum GPCA positivity than healthy control subjects and significantly higher frequencies of anemia, serum vitamin B12 and folic acid deficiencies, and serum GPCA positivity than AG patients without hyperhomocysteinemia.

Topics: Adult; Aged; Aged, 80 and over; Anemia; Atrophy; Autoantibodies; Case-Control Studies; Erythrocyte Count; Erythrocyte Indices; Female; Folic Acid; Glossitis; Hemoglobins; Humans; Hyperhomocysteinemia; Iron; Male; Middle Aged; Parietal Cells, Gastric; Taiwan; Vitamin B 12; Young Adult

Our previous study found that 56 of 1064 atrophic glossitis (AG) patients have vitamin B12 deficiency. This study assessed whether the AG patients with vitamin B12 deficiency (B12D/AG patients) had significantly higher frequencies of anemia, hematinic deficiencies, hyperhomocysteinemia, and serum gastric parietal cell antibody (GPCA) positivity than healthy control subjects.. The blood hemoglobin (Hb) and serum iron, vitamin B12, folic acid, homocysteine, and GPCA levels in 56 B12D/AG patients and 532 healthy control subjects were measured and compared.. We found that 56 B12D/AG patients had significantly lower mean blood Hb and serum iron levels as well as significantly higher mean corpuscular volume (MCV) and mean serum homocysteine level than healthy control subjects (all P-values < 0.05). Moreover, 56 B12D/AG patients had significantly higher frequencies of macrocytosis (53.6%), blood Hb (64.3%), iron (26.8%), and folic acid (3.6%) deficiencies, hyperhomocysteinemia (89.3%), and serum GPCA positivity (55.4%) than 532 healthy control subjects (all P-values < 0.005). In addition, of 36 anemic B12D/AG patients, 22 (61.1%) had pernicious anemia (PA), 6 (16.7%) had macrocytic anemia other than PA, 4 (11.1%) had normocytic anemia, 3 (8.3%) had iron deficiency anemia (IDA), and one (2.8%) had microcytic anemia other than IDA and thalassemia trait-induced anemia.. We conclude that B12D/AG patients have significantly higher frequencies of macrocytosis, blood Hb, iron, and folic acid deficiencies, hyperhomocysteinemia, and serum GPCA positivity than healthy control subjects. PA is the most common type of anemia in our B12D/AG patients.

Topics: Adult; Aged; Aged, 80 and over; Anemia; Autoantibodies; Case-Control Studies; Comorbidity; Erythrocyte Indices; Female; Folic Acid; Folic Acid Deficiency; Glossitis; Hematinics; Hemoglobins; Humans; Hyperhomocysteinemia; Iron; Male; Middle Aged; Parietal Cells, Gastric; Vitamin B 12; Vitamin B 12 Deficiency

Burning mouth syndrome (BMS) is characterized by burning sensation of the oral mucosa in the absence of clinically apparent oral mucosal alterations. This study evaluated the anemia, hematinic deficiencies, hyperhomocysteinemia, and serum gastric parietal cell antibody (GPCA) positivity in 884 BMS patients.. The blood hemoglobin (Hb) and serum iron, vitamin B12, folic acid, homocysteine, GPCA levels in 884 BMS patients were measured and compared with the corresponding levels in 442 age- and sex-matched healthy control subjects.. We found that 175 (19.8%), 143 (16.2%), 42 (4.8%), 20 (2.3%), 170 (19.2%), and 109 (12.3%) BMS patients had blood Hb, serum iron, vitamin B12, and folic acid deficiencies, hyperhomocysteinemia, and serum GPCA positivity, respectively. Moreover, 884 BMS patients had significantly higher frequencies of blood Hb and serum iron, vitamin B12, and folic acid deficiencies, hyperhomocysteinemia, and serum GPCA positivity than 442 healthy control subjects (all P-values < 0.005). Of 175 anemic BMS patients, 95 had normocytic anemia, 27 had thalassemia trait-induced anemia, 21 had iron deficiency anemia, 15 had pernicious anemia, 15 had macrocytic anemia other than pernicious anemia, and 2 had microcytic anemia other than iron deficiency anemia and thalassemia trait-induced anemia. Burning sensation of oral mucosa (100.0%), dry mouth (48.1%), numbness of oral mucosa (30.7%), and dysfunction of taste (16.7%) were the four common symptoms in 884 BMS patients.. BMS patients have significantly higher frequencies of blood Hb and serum iron, vitamin B12, and folic acid deficiencies, hyperhomocysteinemia, and serum GPCA positivity than healthy control subjects.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Anemia; Autoantibodies; Burning Mouth Syndrome; Case-Control Studies; Erythrocyte Indices; Female; Folic Acid; Folic Acid Deficiency; Hemoglobins; Humans; Hyperhomocysteinemia; Iron; Male; Middle Aged; Parietal Cells, Gastric; Vitamin B 12; Vitamin B 12 Deficiency; Young Adult

Topics: Abdominal Pain; Adult; Anemia; Blood Group Incompatibility; Bradycardia; Emergency Service, Hospital; Erythrocyte Transfusion; Fatigue; Female; Fluid Therapy; Headache; Humans; Hypertension; Iron; Nausea; Patient Readmission; Transfusion Reaction; Vitamin B 12; Vitamin B 12 Deficiency; Vitamin B Complex

To determine the prevalence of anemia, and to evaluate the etiology and risk factors of anemia in patients with newly diagnosed cancer.. In this cross-sectional study, 310 patients with newly diagnosed cancer who were referred to a university hospital in Turkey over a 6-month period and 218 age-matched healthy individuals as controls were evaluated in terms of anemia: complete blood count (CBC), ferritin, transferrin saturation (TS%), serum iron (SI), cobalamin (B12), and folate levels. Carcinoma of the breast (21.3%), lung (12.9%), and gastrointestinal tract (GIT) (35.8%) accounted for the majority of the patients, and 44.7% of the patients had metastatic disease.. Anemia was observed in 49.7% of patients with cancer and in 11.9% of healthy controls (p < 0.001). SI and TS% were lower in patients with cancer than in the controls (p < 0.001); however, the median serum ferritin level, which is also an acute-phase reactant, was higher in the patient group than the healthy matched controls (42.2 ng/mL and 41 ng/mL, respectively, p < 0.001). Folate and B12 deficiencies were seen more frequently in the cancer group than in the controls [6.5% and 0.9% (p < 0.001); 39.3% and 18.9% (p < 0.05), respectively]. In the cancer group, anemia was seen more frequently in the metastatic subgroup than in the non-metastatic subgroup (59.7% and 55.3%, respectively, p < 0.05). The prevalence of anemia was similar in both groups of patients with and without primary GIT cancers, as well as in patients who did and did not undergo tumor surgery (p > 0.05).. This study showed that, at the time a patient is diagnosed as having cancer, the patient already has a significant risk for anemia, nearly five times that of healthy people. Having metastatic disease, and having nutritional deficiencies as iron, B12, and folate were evaluated as possible risk factors for anemia in patients with newly diagnosed cancer, whereas cancer with GIT localization and previous history of tumor surgery were not.

Topics: Adult; Aged; Aged, 80 and over; Anemia; Case-Control Studies; Cross-Sectional Studies; Female; Ferritins; Folic Acid; Folic Acid Deficiency; Humans; Iron; Male; Middle Aged; Neoplasms; Prevalence; Risk Factors; Turkey; Vitamin B 12; Vitamin B 12 Deficiency; Young Adult

Topics: Adolescent; Age Factors; Anemia; Child; Cross-Sectional Studies; Female; Ferritins; Folic Acid; Hemoglobins; Humans; Iron; Kuwait; Logistic Models; Male; Risk Factors; Sex Factors; Vitamin B 12

Vitamin B-12 and folate deficiencies in women and children have important public health implications. However, the evidence is conflicting and limited on whether the influence of inflammation on biomarker concentrations may be sufficiently and consistently influenced by inflammation to require adjustment for interpreting concentrations or estimating population prevalence of deficiencies.. We examined correlations between concentrations of the inflammation biomarkers C-reactive protein (CRP) and α1-acid glycoprotein (AGP) and serum vitamin B-12 and serum and RBC folate among nonpregnant women of reproductive age (WRA; 15-49 yr) and preschool children (PSC; 6-59 mo).. We analyzed cross-sectional data from 16 nationally representative nutrition surveys conducted in WRA (n = 32,588) and PSC (n = 8,256) from the Biomarkers Reflecting Inflammation and Nutritional Determinants of Anemia project. Spearman correlations between CRP or AGP and vitamin B-12 or folate concentrations were examined, taking into account complex survey design effects.. Correlations between inflammation and vitamin B-12 or folate were weak, with no clear pattern of association in either WRA or PSC. Correlation coefficients between CRP and vitamin B-12 for WRA and PSC ranged from -0.25 to 0.16, and correlations between AGP and vitamin B-12 ranged between -0.07 and 0.14. Similarly, correlations between CRP and serum folate ranged from -0.13 to 0.08, and correlations between AGP and serum folate between -0.21 and 0.02. Only 3 surveys measured RBC folate, and among them, correlations for WRA ranged from -0.07 to 0.08 for CRP and -0.04 for AGP (1 country).. Based on the weak and inconsistent correlations between CRP or AGP and vitamin B-12 or folate biomarkers, there is no rationale to adjust for inflammation when estimating population prevalence of vitamin B-12 or folate deficiencies in WRA or PSC.

Topics: Adolescent; Adult; Anemia; Biomarkers; C-Reactive Protein; Child; Child, Preschool; Cross-Sectional Studies; Female; Folic Acid; Humans; Infant; Middle Aged; Nutrition Surveys; Orosomucoid; Vitamin B 12; Young Adult

Since evidence of an association between vitamin B12 (B12) deficiency and anemia in older people is limited and inconclusive, we wanted to investigate this association in old, frail nursing home patients.. The study includes patients admitted to short-term, post-acute care (n = 765) and residents in long-term care (LTC) (n = 1665), in the municipality of Bergen. Anemia was defined according to the WHO criteria: Hb < 13 g/dL in men and < 12 g/dL in women, and as Hb < 11 g/dL, in both sex (moderate/severe anemia). The presence of anemia was analyzed in patients with subnormal (< 250 pmol/L), normal (250-650 pmol/L) and high (> 650 pmol/L) B12, and the association between anemia and clinical parameters, and including B12, was analyzed using logistic regression models. The use of B12 supplementation was investigated in the LTC patients.. Mean age of the 2430 patients was 86 ± 7 years. WHO-defined anemia was seen in 1023 (42%), and moderate/severe anemia in 384 (16%) of the patients. In multiple logistic regression analyses, we found no statistically significant associations of subnormal B12 with WHO-defined anemia or moderate/severe anemia. Renal insufficiency, iron deficiency and CRP > 10 mg/L were significantly associated with both types of anemia, (p < 0.001). Among the LTC residents, 405 (24%) received B12 supplements, 112 (7%) of them had elevated B12 > 650 pmol/L.. In older nursing home patients, no association was observed between subnormal B12 and anemia. Older patients in Western societies with mild/moderate anemia should not be treated with B12 supplements without further investigation.

Topics: Aged; Anemia; Dietary Supplements; Female; Humans; Infant, Newborn; Male; Nursing Homes; Vitamin B 12; Vitamin B 12 Deficiency

In patients with pre-operative anaemia undergoing cardiac surgery, combination treatment with intravenous iron, subcutaneous erythropoietin alpha, vitamin B12 and oral folic acid reduces allogeneic blood product transfusions. It is unclear if certain types of anaemia particularly benefit from this treatment. We performed a post-hoc analysis of anaemic patients from a randomised trial on the 'Effect of ultra-short-term treatment of patients with iron deficiency or anaemia undergoing cardiac surgery'. We used linear regression analyses to examine the efficacy of a combination anaemia treatment compared with placebo on the following deficiencies, each representing a part of the combination treatment: ferritin and transferrin saturation; endogenous erythropoietin; holotranscobalamine; and folic acid in erythrocytes. Efficacy was defined as change in reticulocyte count from baseline to the first, third and fifth postoperative days and represented erythropoietic activity in the immediate peri-operative recovery phase. In all 253 anaemic patients, iron deficiency was the most common cause of anaemia. Treatment significantly increased reticulocyte count in all regression analyses on postoperative days 1, 3 and 5 (all p < 0.001). Baseline ferritin and endogenous erythropoietin were negatively associated with change in reticulocyte count on postoperative day 5, with an unstandardised regression coefficient B of -0.08 (95%CI -0.14 to -0.02) and -0.14 (95%CI -0.23 to -0.06), respectively. Quadruple anaemia treatment was effective regardless of the cause of anaemia and its effect manifested early in the peri-operative recovery phase. The more pronounced a deficiency was, the stronger the subsequent boost to erythropoiesis may have been.

Topics: Administration, Intravenous; Aged; Aged, 80 and over; Anemia; Anemia, Iron-Deficiency; Blood Transfusion; Cardiac Surgical Procedures; Double-Blind Method; Drug Therapy, Combination; Erythropoietin; Female; Folic Acid; Hematinics; Humans; Iron; Male; Middle Aged; Postoperative Period; Preoperative Care; Reticulocyte Count; Vitamin B 12; Vitamin B Complex

Anemia of chronic diseases is a condition that accompanies a specific underlying disease, in which there is a decrease in hemoglobin, hematocrit and erythrocyte counts due to a complex process, usually initiated by cellular immunity mechanisms and pro-inflammatory cytokines and hepcidin. This is the second most common type of anemia after iron deficiency anemia in the world. Its severity generally correlates with the severity of the underlying disease. This disease most often coexists with chronic inflammation, autoimmune diseases, cancer, and kidney failure. Before starting treatment, one should undertake in-depth diagnostics, which includes not only assessment of complete blood count and biochemical parameters, but also severity of the underlying disease. The differential diagnosis of anemia of chronic diseases is primarily based on the exclusion of other types of anemia, in particular iron deficiency. The main features of anemia of chronic diseases include mild to moderate lowering of hemoglobin level, decreased percentage of reticulocyte count, low iron and transferrin concentration, but increased ferritin. Due to the increasingly better knowledge of the pathomechanism of chronic diseases and cancer biology, the diagnosis of this anemia is constantly expanding with new biochemical indicators. These include: the concentration of other hematopoietic factors (folic acid, vitamin B

Topics: Anemia; Anemia, Iron-Deficiency; Chronic Disease; Diagnosis, Differential; Ferritins; Folic Acid; Hemoglobins; Humans; Iron; Reticulocyte Count; Transferrin; Vitamin B 12

Atypical dysgeusia such as having the sensation of a sweet tooth is an uncommon clinical presentation in severe depression. First, we present the case of a 67 year-old-man admitted to the psychiatric ward for depression after a suicide attempt by drug ingestion. The patient manifested a sweet taste sensation in the upper and lower gums that increased with mood swings and notably with severe depressive symptoms. Blood tests showed an elevated serum creatinine level (115 μmol/L), a normocytic anemia (hemoglobin 6.5 mmol/L; MCV 96 fL) and a deficit in vitamin B12 (122.4 pmol/L). The patient received vitamin B12 supplementation and was treated with clomipramine, lithium, mirtazapine, modafinil, and olanzapine. He was discharged after improvement of his depressive symptoms and decrease in the sweet taste. On follow-up, the patient's dysgeusia had subsided. Second, we hypothesize that the atypical dysgeusia may have been induced by vitamin B12 deficiency and medical comorbidities, leading to deafferentation (development of erroneous mouth mucosae sensations felt by the patient). This could have been increased by depression. Dysgeusia in elederly patients with depression should be extensively investigated in order to elucidate somatic contributing factors but it may not resolve until improvement of the depressive symptoms.

Topics: Aged; Anemia; Depression; Dysgeusia; Humans; Male; Olanzapine; Vitamin B 12

To study the relationship between atrophic glossitis and anemia, anemia types and other related factors(oral candida infection, xerostomia) in 124 consecutive cases.. One hundred and twenty-four cases with atrophic glossitis and 53 healthy controls were collected from Qingdao local population. The main indexes including general status, oral examination findings, hemoglobin (Hb), mean red blood cell volume (MCV), vitamin B12, ferritin, folic acid, anemia and anemia type, xerostomia and candida infection were statistically analyzed using SPSS 20.0 software package for Student's t test.. Among 124 cases of glossitis group, 48.39% were found with anemia, 41.94% with xerostomia, 79.03% with Candida infection, 29.03% with Vitamin B12 deficiency, 22.58% with ferritin deficiency, 11.29% with folic acid deficiency. The contents of hemoglobin, ferritin and vitamin B12 in glossitis group were significantly lower than those in the control group(P<0.05), and the number of glossitis patients with anemia, xerostomia and candida infection were significantly higher than those in the control group (P<0.05). There was no significant difference in folic acid content between the two groups(P<0.05).. Occurrence of atrophic glossitis is closely related to anemia, vitamin B12 deficiency, ferritin deficiency, xerostomia, oral candida infection. There is no correlation with folic acid deficiency. Patients with atrophic glossitis accompanied by anemia have a higher proportion of macrocytic anemia.

Topics: Anemia; Folic Acid Deficiency; Glossitis; Humans; Vitamin B 12; Vitamin B 12 Deficiency

Subacute combined degeneration (SCD) is a demyelinating disease commonly caused by vitamin B12 deficiency. Several studies have been reported SCD could be accompanied by anemia. However, the correlation between anemia and clinical severity of SCD patients is unclear. In this study, we aim to analyze the clinical characteristics of SCD concomitant with anemia, and investigate the effect of anemia in predicting the severity of SCD.. A total 42 patients were included in the study. Clinical, laboratory, radiological findings, and outcomes from the patients were analyzed. All patients were treated with vitamin B12 for no less than 6 months and a functional disability rating scale was used to evaluate severity of neurological impairment at the time of admission and 3 and 6 months after admission in our study.. 85.7% patients had macrocytosis. Decreased serum vitamin B12 levels were found in 27 patients (64.3%). MRI showed long-segment abnormality on the spinal cord in 22 patients. No differences in rating score were found in patients grouped by sex, age, clinical course, serum vitamin B12, or MRI manifestations at the time of admission or at the follow-up visits. Negative correlation was seen between hemoglobin levels and the clinical severity scores on admission.. Not all patients with SCD concomitant with anemia had decreased serum vitamin B12 level. The inverse correlation between hemoglobin level and clinical severity suggests the degree of anemia can help in evaluating the extent of neurologic impairment.

Topics: Adolescent; Adult; Aged; Anemia; Female; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Subacute Combined Degeneration; Vitamin B 12; Vitamin B 12 Deficiency; Young Adult

Patients undergoing percutaneous endoscopic gastrostomy (PEG) may present protein-energy malnutrition, anemia and deficiencies of hematopoietic factors, e.g., iron, folate and vitamin B12. There are no comprehensive studies on anemia or other hematological changes in PEG-patients. Our aim was to evaluate the hematological status of dysphagic patients that had undergone PEG and its association with clinical outcome.. This research comprises a retrospective study of patients followed by our Artificial Feeding Team, submitted to PEG from 2010 to 2018. Patients were divided into two etiological groups: neurological dysphagia (ND) and head/neck or esophageal disorders (HNE). Laboratory data included serum albumin, hemoglobin, mean corpuscular volume, ferritin, transferrin, iron, vitamin B12 and folate. Survival after PEG was recorded in months, until death or December 2018.. We evaluated 472 patients; 250 (53%) presented anemia at the moment of gastrostomy, mostly normocytic (. Anemia is frequent in PEG-patients, mostly with the features of ACD or multifactorial. It is associated with significant decrease in survival and may be viewed as a marker of severe metabolic distress, signaling poor outcome.

Topics: Adult; Aged; Aged, 80 and over; Anemia; Endoscopy, Digestive System; Female; Folic Acid; Gastrostomy; Humans; Iron; Male; Middle Aged; Portugal; Postoperative Complications; Retrospective Studies; Vitamin B 12; Young Adult

Metformin can cause serum vitamin B12 deficiency, but studies on the influence of its duration and dose are lacking. We investigated vitamin B12 deficiency in patients with type 2 diabetes using metformin, in conjunction with other related factors.. This cross-sectional study included 1111 patients with type 2 diabetes who took metformin for at least 6 months. Serum vitamin B12 levels were quantified using a competitive-binding immunoenzymatic assay, and vitamin B12 deficiency was defined as serum B12 <300 pg/mL. Information on metformin use and confounding variables were collected from records or questionnaires and interviews.. Serum vitamin B12 deficiency occurred in 22.2% of patients (n = 247). After adjusting for confounders, a 1 mg increase in daily metformin dose was associated with a 0.142 pg/mL decrease in vitamin B12 (P < .001). Compared with a daily dose of <1000 mg, the adjusted odds ratios for 1000 to 1500, 1500 to 2000, and ≥2000 mg metformin were 1.72 (P = .080), 3.34 (P < .001), and 8.67 (P < .001), respectively. Vitamin B12 deficiency occurred less often in patients taking multivitamins (odds ratio 0.23; P < .001). After adjusting for confounding factors, there was no correlation between B12 deficiency and duration of metformin use. Serum homocysteine levels showed significant negative correlation with vitamin B12.. Metformin at ≥1500 mg/d could be a major factor related to vitamin B12 deficiency, whereas concurrent supplementation of multivitamins may potentially protect against the deficiency. Serum homocysteine levels were negatively correlated with vitamin B12 levels, suggesting that B12 deficiency due to metformin use may occur at the tissue level. However, this hypothesis will require further study.

Topics: Age Factors; Aged; Alcohol Drinking; Anemia; Cross-Sectional Studies; Diabetes Mellitus, Type 2; Dose-Response Relationship, Drug; Female; Folic Acid; Homocysteine; Humans; Hypoglycemic Agents; Male; Metformin; Middle Aged; Odds Ratio; Republic of Korea; Time Factors; Vitamin B 12; Vitamin B 12 Deficiency; Vitamins

Topics: Anemia; Diagnosis, Differential; Female; Glossitis; Humans; Iron; Pregnancy; Pregnancy Complications, Hematologic; Prenatal Diagnosis; Vitamin B 12; Young Adult

Megaloblastic, nonregenerative anemia is a well-known consequence of cobalamin or folate deficiencies in humans but is not recognized in hypocobalaminemic or hypofolatemic dogs. Establishment of relationships between hypocobalaminemia or hypofolatemia and hematologic disease would encourage vitamin B testing, and potentially supplementation, in anemic dogs.. To determine the prevalence of anemia in hypocobalaminemic or hypofolatemic dogs and to report the prevalence of hypocobalaminemia and hypofolatemia and nonregenerative anemia, macrocytosis, and anisocytosis in anemic dogs.. One hundred and fourteen client-owned dogs with known serum cobalamin and folate concentrations and CBCs and 42 client-owned anemic dogs.. Retrospective comparison of anemia prevalence in hypocobalaminemic or hypofolatemic and normocobalaminemic or normofolatemic dogs was performed. Prospective measurement of erythrocyte variables and cobalamin and folate concentrations in anemic dogs was carried out; relationships among hypocobalaminemia and regenerative status, mean corpuscular volume, and red cell distribution width were evaluated.. Significant differences in prevalence of anemia between hypocobalaminemic (36%) and normocobalaminemic dogs (26%; P = .23) or between hypofolatemic (31%) and normofolatemic dogs (30%; P = .99) were not detected. Between hypocobalaminemic and normocobalaminemic dogs, no significant differences in prevalence of nonregenerative anemia (69% vs 63%; P = .65), macrocytosis (17% vs 0%; P = .53), or anisocytosis (28% vs 0%; P = .14) were detected. Anemic dogs had high prevalence of vitamin B deficiencies (nonregenerative: 64% hypocobalaminemic, 18% hypofolatemic; regenerative: 57% hypocobalaminemic, 21% hypofolatemic).. The association between cobalamin and folate deficiencies and macrocytic, nonregenerative anemia established in humans is not routinely present in dogs.

Topics: Anemia; Animals; Case-Control Studies; Dog Diseases; Dogs; Female; Folic Acid; Folic Acid Deficiency; Male; Prevalence; Retrospective Studies; Vitamin B 12; Vitamin B 12 Deficiency

Approximately 27% of atrophic glossitis (AG) patients have the serum gastric parietal cell antibody (GPCA) positivity. This study assessed whether the serum GPCA or AG itself was a significant factor causing anemia, hematinic deficiencies, and hyperhomocysteinemia in GPCA-positive AG (GPCA. The mean corpuscular volume (MCV) and mean blood hemoglobin (Hb), iron, vitamin B12, folic acid, and homocysteine levels were measured and compared between any two of three groups of 284 GPCA. Both 284 GPCA. The disease of AG itself is a significant factor causing anemia, hematinic deficiencies, and hyperhomocysteinemia in both GPCA

Topics: Adult; Aged; Aged, 80 and over; Anemia; Atrophy; Autoantibodies; Case-Control Studies; Erythrocyte Count; Erythrocyte Indices; Female; Folic Acid; Glossitis; Hemoglobins; Humans; Hyperhomocysteinemia; Iron; Male; Middle Aged; Parietal Cells, Gastric; Taiwan; Vitamin B 12; Young Adult

Topics: Adult; Ambulatory Care Facilities; Anemia; Case-Control Studies; Colitis, Ulcerative; Eating; Erythrocyte Count; Female; Hospitals, University; Humans; Iron; Male; Meat Products; Meat Proteins; Middle Aged; Nutrients; Poland; Statistics, Nonparametric; Vitamin B 12; Young Adult

Our previous study found that 177 of 1064 atrophic glossitis (AG) patients have serum gastric parietal cell antibody (GPCA) positivity only (so-called GPCA. The mean blood hemoglobin (Hb), iron, vitamin B12, folic acid, and homocysteine levels were measured and compared between any two of three groups of 177 GPCA. GPCA. The GPCA is a major factor causing vitamin B12 deficiency and hyperhomocyteinemia in GPCA

Topics: Adult; Aged; Aged, 80 and over; Anemia; Atrophy; Autoantibodies; Erythrocyte Indices; Female; Folic Acid; Glossitis; Hemoglobins; Humans; Hyperhomocysteinemia; Iron; Male; Middle Aged; Parietal Cells, Gastric; Taiwan; Vitamin B 12; Young Adult

Anemia prevalence in India remains high despite preventive iron supplementation programs. Consequently, concurrent national policies of iron fortification of staple foods have been initiated.. This study evaluated the relation between dietary iron intake and anemia (hemoglobin <12 g/dL) in women of reproductive age (WRA; 15-49 y) with respect to iron fortification in India.. Data from 2 national surveys were used. Data on hemoglobin in WRA were sourced from the National Family Health Survey-4, whereas dietary intakes were sourced from the National Sample Survey. Adjusted odds for anemia with increasing iron intake were estimated, along with the effect of modulating nutrients such as vitamins B-12 and C, from statistically matched household data from the 2 surveys. The risks of inadequate (less than the Estimated Average Requirement for WRA) and excess (more than the tolerable upper limit for WRA) intakes of iron were estimated by the probability approach.. The relation between iron intake and the odds of anemia was weak (OR: 0.992; 95% CI: 0.991, 0.994); increasing iron intake by 10 mg/d reduced the odds of anemia by 8%. Phytate and vitamin B-12 and C intakes modified this relation by reducing the odds by 1.5% when vitamin B-12 and C intakes were set at 2 μg/d and 40 mg/d, respectively. The additional intake of 10 mg/d of fortified iron reduced the risk of dietary iron inadequacy from 24-94% to 9-39% across states, with no risk of excess iron intake. Approximately doubling this additional iron intake reduced the risk of inadequacy to 2-12%, but the risk of excess intake reached 22%.. Providing fortified iron alone may not result in substantial anemia reduction among WRA in India and could have variable benefits and risks across states. Geographically nuanced dietary strategies that include limited fortification and the intake of other beneficial nutrients should be carefully considered.

Topics: Adolescent; Adult; Anemia; Anemia, Iron-Deficiency; Ascorbic Acid; Diet; Energy Intake; Female; Food, Fortified; Health Surveys; Hemoglobins; Humans; India; Iron; Iron Overload; Iron, Dietary; Middle Aged; Phytic Acid; Risk Factors; Vitamin B 12; Young Adult

Our previous studies found relatively higher frequencies of anemia, hematinic deficiencies, and hyperhomocysteinemia in patients with different types of oral mucosal diseases. This study evaluated whether patients with oral precancerous lesions (oral precancer patients) had significantly higher frequencies of anemia, hematinic deficiencies, and hyperhomocysteinemia than healthy control subjects.. The complete blood count, serum iron, vitamin B12, folic acid, and homocysteine levels in 131 oral precancer patients including 96 oral leukoplakia, 26 oral erythroleukoplakia, and 9 oral verrucous hyperplasia patients and in 131 age- and sex-matched healthy control subjects were measured and compared.. We found significantly lower mean serum iron (for women only), vitamin B12, and folic acid levels and a significantly higher mean serum homocysteine level in oral precancer patients than in healthy control subjects (all P-values < 0.05). Moreover, 131 oral precancer patients had significantly higher frequencies of blood hemoglobin (3.1%), vitamin B12 (43.5%), and folic acid (46.6%) deficiencies and hyperhomocysteinemia (22.1%) than 131 healthy control subjects (all P-values < 0.05). Of 131 oral precancer patients, lower mean serum folic acid levels were found in 87 cigarette smokers than in 44 non-smokers (P = 0.002), in 26 smokers consuming > 20 cigarettes per day than in 61 smokers consuming ≤ 20 cigarettes per day (P = 0.024), and in 52 betel quid chewers than in 79 non-chewers (P = 0.051).. There are significantly higher frequencies of anemia, serum vitamin B12, and folic acid deficiencies, and hyperhomocysteinemia in oral precancer patients than in healthy control subjects.

Topics: Adult; Aged; Anemia; Autoantibodies; Case-Control Studies; Erythrocyte Indices; Female; Folic Acid; Folic Acid Deficiency; Hematinics; Hemoglobins; Humans; Hyperhomocysteinemia; Iron; Leukoplakia, Oral; Male; Middle Aged; Mouth Diseases; Parietal Cells, Gastric; Sex Factors; Taiwan; Vitamin B 12; Vitamin B 12 Deficiency

Microcytosis is defined as having mean corpuscular volume (MCV) < 80 fL. This study evaluated whether 79 atrophic glossitis (AG) patients with microcytosis and 985 AG patient without microcytosis had higher frequencies of anemia, hematinic deficiencies, hyperhomocysteinemia, and serum gastric parietal cell antibody (GPCA) positivity than 532 healthy control subjects.. Complete blood count, serum iron, vitamin B12, folic acid, homocysteine, and serum GPCA levels in 79 AG patients with microcytosis, 985 AG patient without microcytosis, and 532 healthy control subjects were measured and compared.. We found that 69.6%, 43.0%, 5.1%, 3.8%, 11.4%, and 22.8% of 79 AG patients with microcytosis and 14.9%, 14.8%, 5.3%, 2.1%, 12.0%, and 27.0% of 985 AG patients without microcytosis were diagnosed as having blood hemoglobin, iron, vitamin B12, and folic acid deficiencies, hyperhomocysteinemia, and serum GPCA positivity, respectively. Both 79 AG patients with microcytosis and 985 AG patients without microcytosis had significantly higher frequencies of blood hemoglobin, iron, vitamin B12, and folic acid deficiencies, hyperhomocysteinemia, and serum GPCA positivity than 532 healthy control subjects (all P-values < 0.01). Moreover, 79 AG patients with microcytosis had significantly higher frequencies of blood hemoglobin and iron deficiencies than 985 AG patients without microcytosis.. There are significantly higher frequencies of anemia, serum iron, vitamin B12, and folic acid deficiencies, hyperhomocysteinemia, and serum GPCA positivity in AG patients with or without microcytosis than in healthy control subjects. AG patients with microcytosis have significantly higher frequencies of blood hemoglobin and iron deficiencies than AG patients without microcytosis.

Topics: Adult; Aged; Aged, 80 and over; Anemia; Atrophy; Autoantibodies; Case-Control Studies; Erythrocyte Indices; Erythropoiesis; Female; Folic Acid; Folic Acid Deficiency; Glossitis; Hemoglobins; Homocysteine; Humans; Hyperhomocysteinemia; Iron; Iron Deficiencies; Male; Middle Aged; Parietal Cells, Gastric; Tongue; Vitamin B 12; Vitamin B 12 Deficiency; Young Adult

Macrocytosis is defined as having the mean corpuscular volume (MCV) ≧ 100 fL. This study evaluated whether 41 atrophic glossitis (AG) patients with macrocytosis had significantly higher frequencies of anemia, hematinic deficiencies, hyperhomocysteinemia, and serum gastric parietal cell antibody (GPCA) positivity than 532 healthy control subjects or 1064 AG patients.. Complete blood count, serum iron, vitamin B12, folic acid, homocysteine, and GPCA levels in 41 AG patients with macrocytosis, 1064 AG patients, and 532 healthy control subjects were measured and compared.. We found that 73.2%, 22.0%, 73.2%, 4.9%, 80.5%, and 56.1% of 41 AG patients with macrocytosis were diagnosed as having blood hemoglobin, iron, vitamin B12, and folic acid deficiencies, hyperhomocysteinemia, and serum GPCA positivity, respectively. Moreover, 41 AG patients with macrocytosis had significantly higher frequencies of blood hemoglobin and serum vitamin B12 deficiencies, hyperhomocysteinemia, and serum GPCA positivity than 532 healthy control subjects or 1064 AG patients (all P-values < 0.001). In addition, 41 AG patients with macrocytosis also had significantly higher frequencies of serum iron and folic acid deficiencies than 532 healthy control subjects (both P-values < 0.001). Pernicious anemia was found in 22 AG patients with macrocytosis.. There are significantly higher frequencies of anemia and serum iron, vitamin B12, and folic acid deficiencies, hyperhomocysteinemia, and serum GPCA positivity in AG patients with macrocytosis than in healthy control subjects. AG patients with macrocytosis also have significantly higher frequencies of blood hemoglobin and serum vitamin B12 deficiencies, hyperhomocysteinemia, and serum GPCA positivity than AG patients.

Topics: Adult; Aged; Aged, 80 and over; Anemia; Anemia, Macrocytic; Atrophy; Autoantibodies; Case-Control Studies; Erythrocyte Indices; Female; Folic Acid; Glossitis; Hematinics; Hematologic Diseases; Hemoglobins; Homocysteine; Humans; Hyperhomocysteinemia; Iron; Male; Middle Aged; Parietal Cells, Gastric; Tongue; Vitamin B 12; Young Adult

The aim of this study was to evaluate the prevalence of anemia and other vitamin deficiencies among elderly home care patients and to evaluate the causes of anemia and effect of malnutrition as a contributing factor.. Anemia was defined according to the World Health Organization. Hemogram, serum iron, iron binding capacity, ferritin and transferrin saturation values, serum vitamin B12, folic acid and vitamin D levels were evaluated. It was tried to differentiate as absolute iron deficiency anemia, anemia of chronic disease, anemia of unknown cause and vitamin B12 deficiency anemia. Malnutrition was evaluated by Mini Nutritional Assessment test.. Total of 472 patients (mean age 81,4±7,4 years) were included in the study. Anemia was detected in 179 (%37,9) patients, 22,7% of males and 45,5 % of female. Prevalence of iron deficiency anemia, vitamin B12, folic acid and vitamin D deficiencies were found 43%, 46%, 19% and 91% respectively. 22,8% of all patients were malnourished, 17,5% were under malnutrition risk. In patients with anemia 16,2% chronic disease anemia and 37,4% unknown anemia were detected.. With or without malnutrition, iron deficiency anemia, vitamin B12 deficiency and vitamin D deficiency were common in the home care elderly patients.

Topics: Aged; Anemia; Anemia, Iron-Deficiency; Chronic Disease; Female; Ferritins; Folic Acid; Folic Acid Deficiency; Home Care Services; Homes for the Aged; Humans; Male; Malnutrition; Nutrition Assessment; Nutritional Status; Prevalence; Vitamin B 12; Vitamin B 12 Deficiency; Vitamin D Deficiency

Blood test results required for the evaluation of anemia are considered difficult to interpret after red blood cell transfusion. However, this hypothesis is neither supported by a strong physiological rationale nor is it evidence based.. We conducted a prospective multicenter study to compare the values of key assays prior to and after a course of red blood cell transfusion in the emergency or internal medicine units in 4 university hospitals. The following parameters were measured prior to and within 48 to 72 hours after transfusion: complete blood count with reticulocyte count, direct Coombs' test, ferritin, transferrin saturation, soluble transferrin receptor, serum and erythrocyte folate, cobalamin, lactate dehydrogenase, bilirubin, haptoglobin, and C-reactive protein. We investigated the impact of transfusion on these parameters and assessed whether abnormal values prior to the transfusion became normal after transfusion (or conversely).. There were 77 patients included in the study. Changes in mean values of mean corpuscular volume, soluble transferrin receptor, erythrocyte folate, cobalamin, haptoglobin, lactate dehydrogenase, C-reactive protein, and direct Coombs' test were not statistically significant. Changes in reticulocyte count, ferritin, transferrin saturation, serum folate, and total bilirubin concentrations were statistically significant, but they remained in the same diagnostic category (normal or abnormal) in 79% to 98% of the cases; 97% of patients with iron deficiency still had low ferritin or transferrin saturation after a transfusion.. Blood tests performed after a one-time red blood cell transfusion can be used to establish the cause of anemia when they have not been performed before.

Topics: Acute-Phase Proteins; Adult; Aged; Aged, 80 and over; Anemia; Bilirubin; Biomarkers; Blood Cell Count; Erythrocyte Transfusion; Female; Folic Acid; Humans; Iron-Binding Proteins; Male; Middle Aged; Prospective Studies; Vitamin B 12

Many surgeons believe mini gastric bypass (MGB) is more likely to cause micronutrient malabsorption compared to Roux-en-Y gastric bypass (RYGB). Till date, there is no published study evaluating haematological indices and haematinic levels in patients undergoing MGB and comparing these with a matched cohort of RYGB. Two hundred patients who underwent MGB between October 2012 and October 2015 were matched to 200 patients who underwent RYGB for age, sex, body mass index and time of surgery. We then compared haemoglobin, mean corpuscular volume, iron, ferritin, vitamin B12 and folic acid levels preoperatively and at 6 monthly intervals after surgery until 2 years. The percentage total weight loss was significantly higher in the MGB group compared to the RYGB group at all time points. At 2 years, MGB and RYGB both led to an increase in anaemia rates but the difference was only significant for MGB group. Compared to RYGB, MGB patients were more likely to be anaemic at 2 years, although the difference was not significant statistically (16.6% vs. 12.7%; P value = 0.55). There was a trend for lower iron and folate levels in MGB group compared to RYGB group but the difference was statistically significant at some of the time periods only (significantly lower folate at 6 and 12 months and lower iron at 6 months in the MGB group). MGB leads to a significant increase in anaemia rates in a supplemented cohort. There is a trend towards lower iron and folate levels and higher anaemia rates in MGB group in comparison with RYGB. Larger studies with longer follow-up should evaluate results of MGB with a shorter biliopancreatic limb.

Topics: Adult; Anemia; Biomarkers; Databases, Factual; England; Erythrocyte Indices; Female; Ferritins; Folic Acid; Gastric Bypass; Hemoglobins; Humans; Incidence; Iron; Male; Middle Aged; Nutritional Status; Obesity; Prevalence; Time Factors; Treatment Outcome; Vitamin B 12

Endobarrier® is a minimally invasive, reversible endoscopic treatment for obesity. It provokes malabsorption along 60 cm of the small intestine, which can contribute to the development of vitamin deficiencies and to changes in bone mineral density (BMD). To determine the prevalence of nutrient deficiencies, changes in body composition and BMD during the first year after Endobarrier® placement. Twenty-one patients with type 2 diabetes met inclusion criteria. Levels of vitamins, micro and macronutrients were assessed prior and at 1, 3 and 12 months post-operatively. DEXA was performed before and 12 months after implant. Nineteen patients completed the 12 months follow-up. Vitamin D deficiency was the most prevalent finding before Endobarrier® implant. The percentage of patients with severe deficiency decreased from 19 to 5% at 12 months after supplementation. Microcytic anaemia was initially present in 9.5% of patients and increased to 26.3% at 12 months. Low ferritin and vitamin B12 levels were observed in 14.2 and 4.8% of patients before the implant and worsened to 42 and 10.5%. Low concentrations of magnesium and phosphorus were also common but improved along the study. A significant but not clinically relevant decrease in BMD of 4.14 ± 4.0% at the femoral neck was observed at 12 months without changes in osteocalcin levels. Vitamin deficiencies are common after Endobarrier® implant. It is therefore important to screen patients prior to and at regular intervals after the implant, and to encourage adherence to diet counselling and supplementation.

Topics: Anemia; Avitaminosis; Bone Density; Deficiency Diseases; Diabetes Mellitus, Type 2; Female; Femur Neck; Ferritins; Humans; Intestinal Absorption; Intestine, Small; Magnesium; Male; Middle Aged; Obesity; Phosphorus; Prostheses and Implants; Vitamin B 12; Vitamin B 12 Deficiency; Vitamin D Deficiency

Behcet's disease (BD) patients may have one or more hematinic deficiencies. This study evaluated whether there were significantly higher frequencies of hemoglobin, iron, vitamin B12, and folic acid deficiencies and of hyperhomocysteinemia in BD patients.. The blood hemoglobin, iron, vitamin B12, folic acid, and homocysteine concentrations in 63 BD patients were measured and compared with the corresponding levels in 126 age- and sex-matched healthy control subjects.. We found that 30.2%, 34.9%, 6.3%, 6.3%, and 14.3% of 63 BD patients had hemoglobin, iron, vitamin B12, and folic acid deficiencies and hyperhomocysteinemia, respectively. Both 63 BD and 19 major-typed RAS/BD patients had significantly higher frequencies of hemoglobin, iron, vitamin B12, and folic acid deficiencies and of hyperhomocysteinemia than 126 healthy control subjects (all P-values < 0.05). Moreover, 44 minor-typed RAS/BD patients had significantly higher frequencies of hemoglobin and iron deficiencies than 126 healthy control subjects (both P-values < 0.001). Of the 19 anemic BD patients, one had pernicious anemia, one had macrocytic anemia, 12 had normocytic anemia, four had iron deficiency anemia, and one had thalassemia trait-induced anemia.. There are significantly higher frequencies of hemoglobin, iron, vitamin B12, and folic acid deficiencies and of hyperhomocysteinemia in BD patients. The normocytic anemia is the most common type of anemia in our 63 BD patients. We suggest that supplementations of vitamin BC capsules plus deficient vitamin B12 and/or folic acid may reduce the abnormally high serum homocysteine level to a relatively lower level in BD patients with hyperhomocysteinemia.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Anemia; Behcet Syndrome; Case-Control Studies; Erythrocyte Indices; Female; Folic Acid; Folic Acid Deficiency; Hematinics; Hemoglobins; Homocysteine; Humans; Hyperhomocysteinemia; Iron; Male; Middle Aged; Taiwan; Vitamin B 12; Vitamin B 12 Deficiency; Young Adult

The rising rates of bariatric surgery (BS) are accompanied by neurological complications related to nutrient deficiencies. One of the risk factors for neurological complications in BS patients is poor vitamin and mineral supplementation. Prevention, diagnosis and treatment of these disorders are necessary parts of lifelong care after BS. Particularly important for optimal functioning of the nervous system are vitamin B

Topics: Adult; Anemia; Dietary Supplements; Female; Folic Acid; Gastric Bypass; Humans; Minerals; Nervous System Diseases; Obesity, Morbid; Vitamin B 12; Vitamin B 12 Deficiency; Vitamins

Iron deficiency (ID) in infancy is related to subsequent behavior problems. The effects of micronutrient status in middle childhood are uncertain.. The aim of the study was to examine the associations of micronutrient status biomarkers in middle childhood with externalizing and internalizing behavior problems in adolescence.. We assessed whether ID (ferritin <15 µg/L), anemia (hemoglobin <12.7 g/dL), or blood concentrations of zinc, vitamins A and B-12, and folate at ages 5-12 y were associated with externalizing or internalizing behavior problems in adolescence in 1042 schoolchildren from Bogotá, Colombia. Behavior problems were assessed with the Youth Self-Report questionnaire after a median 6.2 y of follow-up. Mean problem score differences with 95% CIs were estimated between categories of micronutrient status biomarkers with the use of multivariable linear regression.. Mean ± SD externalizing and internalizing problems scores were 52.6 ± 9.6 and 53.8 ± 9.9, respectively. Among boys, middle-childhood ID, anemia, and low plasma vitamin B-12 were associated with 5.9 (95% CI: 1.0, 10.7), 6.6 (95% CI: 1.9, 11.3), and 2.7 (95% CI: 0.4, 4.9) units higher mean externalizing problems scores in adolescence, respectively-after adjustment for baseline age, time spent watching television or playing video games, mother's height, and socioeconomic status. Also in boys, ID was related to an adjusted 6.4 (95% CI: 1.2, 11.6) units higher mean internalizing problems score. There were no associations among girls. Other micronutrient status biomarkers were not associated with behavior problems.. ID, anemia, and low vitamin B-12 in middle childhood are related to behavior problems in adolescent boys.This study was registered at clinicaltrials.gov as NCT03297970.

Topics: Adolescent; Adolescent Behavior; Anemia; Biomarkers; Child; Colombia; Female; Ferritins; Folic Acid; Humans; Iron; Iron Deficiencies; Linear Models; Male; Mental Disorders; Micronutrients; Nutritional Status; Self Report; Students; Vitamin A; Vitamin B 12; Vitamin B 12 Deficiency; Zinc

Iron (Fe) status of neonates born to women carrying multiple fetuses might be compromised as a consequence of the high prevalence of maternal Fe deficiency and anemia coupled with an increased risk of preterm birth. This study aimed to characterize and identify determinants of anemia in this neonatal population.. Umbilical cord blood obtained from 183 neonates was utilized to assess hemoglobin (Hb), ferritin (SF), soluble transferrin receptor (sTfR), hepcidin, serum Fe, erythropoietin, folate, vitamin B-12, C-reactive protein, and interleukin-6. Associations with maternal Fe status were explored.. Cord Hb or SF did not change significantly as a function of gestational age at birth (25-38 wks). Neonates born to women who were obese prior to pregnancy or smoked cigarettes during pregnancy had a 4-5-fold greater odds of anemia at birth. Cord sTfR was the strongest indicator of cord Hb (P < 0.0001), and it was significantly associated with maternal sTfR at mid-gestation (P = 0.01) and delivery (P = 0.002). Cord Fe indicators were significantly associated with cord hepcidin, but not maternal hepcidin.. Screening for Fe status in neonates born to women carrying multiple fetuses is warranted, especially for those born to smokers or to women who are obese at entry into pregnancy.

Topics: Adult; Anemia; Anemia, Iron-Deficiency; C-Reactive Protein; Cohort Studies; Erythropoietin; Female; Ferritins; Fetal Blood; Folic Acid; Hemoglobins; Hepcidins; Humans; Infant, Newborn; Infant, Newborn, Diseases; Infant, Premature; Infant, Premature, Diseases; Interleukin-6; Iron; Obesity; Pregnancy; Pregnancy Complications; Pregnancy, Multiple; Premature Birth; Receptors, Transferrin; Smoking; Tobacco Use Disorder; Vitamin B 12; Young Adult

Atrophic glossitis (AG) patients are prone to have anemia, hematinic deficiencies, hyperhomocysteinemia, and serum gastric parietal cell antibody (GPCA) positivity. This study evaluated whether 1064 AG patients had significantly higher frequencies of anemia, hematinic deficiencies, hyperhomocysteinemia, and serum GPCA positivity than 532 healthy control subjects.. The complete blood count, serum iron, vitamin B12, folic acid, homocysteine, and serum GPCA levels in 1064 AG patients and 532 age- and sex-matched healthy control subjects were measured and compared.. We found that 7.4%, 3.9%, 19.0%, 16.9%, 5.3%, 2.3%, 11.9%, and 26.7% of 1064 AG patients were diagnosed as having microcytosis, macrocytosis, hemoglobin, iron, vitamin B12, and folic acid deficiencies, hyperhomocysteinemia, and serum GPCA positivity, respectively. Moreover, 1064 AG patients had significantly higher frequencies of microcytosis, macrocytosis, hemoglobin, iron, vitamin B12, and folic acid deficiencies, hyperhomocysteinemia, and serum GPCA positivity than 532 healthy control subjects (all P-values < 0.005). Of the 202 anemic AG patients, 22 had pernicious anemia, eight had macrocytic anemia rather than pernicious anemia, 117 had normocytic anemia, 30 had iron deficiency anemia, and 21 had thalassemia trait-induced anemia, and four had microcytic anemia rather than iron deficiency anemia and thalassemia trait-induced anemia.. There are significantly higher frequencies of anemia, serum iron, vitamin B12, and folic acid deficiencies, hyperhomocysteinemia, and serum GPCA positivity in AG patients than in healthy control subjects. The normocytic anemia and iron deficiency anemia are the two most common types of anemia in our 1064 AG patients.

Topics: Adult; Aged; Aged, 80 and over; Anemia; Atrophy; Autoantibodies; Case-Control Studies; Erythrocyte Count; Erythrocyte Indices; Female; Folic Acid; Glossitis; Hemoglobins; Humans; Hyperhomocysteinemia; Iron; Male; Middle Aged; Parietal Cells, Gastric; Taiwan; Vitamin B 12; Young Adult

Topics: Anemia; Humans; Infant; Refugees; Vitamin B 12

Topics: Anemia; Humans; Infant; Refugees; Vitamin B 12

Microcytosis is defined as mean corpuscular volume (MCV) < 80 fL. This study assessed the anemia statuses and hematinic deficiencies in 30 patients with gastric parietal cell antibody-positive microcytosis (GPCA+/microcytosis) and 210 patients with GPCA-negative microcytosis (GPCA-/microcytosis).. We measured and compared the mean red blood cell (RBC) count, MCV, and RBC distribution width (RDW), as well as blood levels of hemoglobin, iron, vitamin B12, folic acid, and homocysteine among the aforementioned patient groups and 240 healthy controls.. We conclude that GPCA in microcytosis patients' sera may have caused significantly lower mean vitamin B12 level as well as significantly higher mean RDW and serum homocysteine level in our GPCA+/microcytosis patients than in GPCA-/microcytosis patients. Herein, iron deficiency anemia was the most common type of anemia in anemic GPCA+/microcytosis and GPCA-/microcytosis patients.

Topics: Adult; Aged; Aged, 80 and over; Anemia; Autoantibodies; Erythrocyte Count; Erythrocyte Indices; Female; Homocysteine; Humans; Male; Middle Aged; Mouth Diseases; Mouth Mucosa; Parietal Cells, Gastric; Vitamin B 12

Micronutrient deficiencies can compromise the development potential of school-aged children, and their later health and productivity as adults. School feeding and school-based fortification approaches have been utilized globally to redress nutritional deficiencies in this age group.. We explored the acceptability and micronutrient impact of a Bangladesh Government supported school-based micronutrient fortification program for children attending rural primary schools in 10 disadvantaged sub-districts.. We applied a mixed methods approach. The quantitative component assessed the impact of micronutrient fortification on 351 children aged 6-11 years using a cohort pre-post research design with a control group. The qualitative component explored the acceptability of the intervention using focus group discussions, body mapping and semi-structured interviews with teachers, school-going children and school authorities.. Daily consumption of fortified biscuits by primary school children had a significant positive impact on mean levels of iron, folic acid, vitamin B12, retinol and vitamin D controlling for sex, baseline deficiency status, CRP, and H. pylori. Levels of anemia and vitamin D deficiency were also significantly reduced. Qualitative findings indicated the widespread acceptability of the daily biscuit. Teachers perceived students to be more attentive in class, less tired, and some attributed better school performance to biscuit consumption. Children reported similar improvements in concentration and energy levels.. This study is among the first in Bangladesh to comprehensively assess a school-based fortification program in terms of its acceptability and impact on micronutrient status of children aged 6-11 years of age. While results strongly support this modality of school feeding, research on the cognitive impacts of micronutrient fortified biscuits will help clarify the case for scaled-up investments in school- based feeding program in Bangladesh and other low and middle income countries.

Topics: Anemia; Bangladesh; Child; Child Nutrition Disorders; Female; Folic Acid; Food, Fortified; Humans; Iron; Male; Micronutrients; Vitamin A; Vitamin B 12; Vitamin D; Vitamin D Deficiency; Vitamins

Topics: Adolescent; Adult; Anemia; Belize; Erythrocytes; Female; Folic Acid; Folic Acid Deficiency; Hemoglobins; Humans; Middle Aged; Nutrition Surveys; Nutritional Status; Prevalence; Risk Factors; Vitamin B 12; Vitamin B 12 Deficiency; Vitamin B Complex; Young Adult

Lymphocytic gastritis is an idiopathic disease, characterized by intraepithelial infiltration of large numbers of T lymphocytes and often described in association with coeliac disease and Helicobacter pylori infection. Although usually associated with iron deficiency anaemia, there is no description on the association between lymphocytic gastritis and secondary vitamin B

Topics: Aged; Anemia; Chronic Disease; Ferrous Compounds; Gastritis; Helicobacter Infections; Helicobacter pylori; Hemoglobins; Humans; Male; Recurrence; T-Lymphocytes; Vitamin B 12; Vitamin B 12 Deficiency

Transcobalamin deficiency (OMIM 275350) is a rare autosomal recessive disease presenting with nonspecific clinical features in early infancy. We report the clinical and laboratory manifestations of 7 children diagnosed with transcobalamin deficiency. All patients were admitted between 2 and 4 months of age with anemia, thrombocytopenia, and hyperhomocysteinemia. The most common complaints at admission were pallor, weakness, and poor feeding. Genetic analysis was performed in 5 patients and it revealed the same homozygous mutation. We initially treated all patients with intramuscular injections of a maximum of 1 mg cyanocobalamin (CN-Cbl) daily and with a final dose of 1 mg per week. Hemoglobin and platelet counts significantly decreased upon decrease or cessation of CN-Cbl therapy. The patients were reevaluated between 2 and 4 years of age and all had delay in speech and walking. In conclusion, 1 mg of intramuscular CN-Cbl every week suffices for hematological improvement but not for normal neurological development in patients who all had relapse due to decrease or cessation of treatment.

Topics: Anemia; Codon, Nonsense; Combined Modality Therapy; Developmental Disabilities; Diagnosis, Differential; Erythrocyte Transfusion; Female; Frameshift Mutation; Homozygote; Humans; Hyperhomocysteinemia; Infant; Male; Platelet Transfusion; Retrospective Studies; Sequence Deletion; Thrombocytopenia; Transcobalamins; Turkey; Vitamin B 12; Vitamin B 12 Deficiency

Approximately 13% of recurrent aphthous stomatitis (RAS) patients have serum anti-gastric parietal cell antibody (GPCA) positivity. This study assessed whether serum GPCA or RAS itself was a significant factor causing hematinic deficiencies and anemia statuses in GPCA-positive RAS (GPCA+/RAS) and all autoantibodies-negative RAS (Abs-/RAS) patients.. The mean corpuscular volume (MCV) and mean blood hemoglobin (Hb), iron, vitamin B12, and folic acid levels were measured and compared between any two of three groups of 31 GPCA+/RAS patients, 240 Abs-/RAS patients, and 342 healthy control subjects.. GPCA+/RAS patients had significantly lower mean Hb and serum iron level (for women only) as well as significantly greater frequencies of Hb, iron, and vitamin B12 deficiencies than healthy control subjects. Moreover, GPCA+/RAS patients had a significantly higher MCV and a significantly greater frequency of vitamin B12 deficiency than Abs-/RAS patients. Furthermore, Abs-/RAS patients did have significantly lower mean Hb, MCV, iron, and folic acid levels and significantly greater frequencies of Hb, iron, vitamin B12, and folic acid deficiencies than healthy control subjects. Of 31 GPCA+/RAS patients, 3 (9.7%) had PA, 6 (19.4%) had vitamin B12 deficiency, and 3 (9.7%) had macrocytosis. Moreover, normocytic anemia (54.0%) and iron deficiency anemia (26.4%) are the two more common types of anemia in our RAS patients.. We conclude that serum GPCA plays a significant role in causing vitamin B12 deficiency and high MCV in GPCA+/RAS patients. RAS itself does play a significant role in causing anemia and hematinic deficiencies in both GPCA+/RAS and Abs-/RAS patients.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Anemia; Anemia, Iron-Deficiency; Anemia, Macrocytic; Autoantibodies; Case-Control Studies; Erythrocyte Indices; Female; Folic Acid; Folic Acid Deficiency; Hemoglobins; Humans; Iron; Male; Middle Aged; Parietal Cells, Gastric; Stomatitis, Aphthous; Taiwan; Vitamin B 12; Vitamin B 12 Deficiency; Young Adult

To study the regional variability of requests for anaemia chemistry tests in primary care in Spain and the associated economic costs of potential over-requesting.. Requests for anaemia tests were examined in a cross-sectional study. Clinical laboratories from different autonomous communities (AACCs) were invited to report on primary care anaemia chemistry tests requested during 2014. Demand for iron, ferritin, vitamin B12 and folate tests per 1000 inhabitants and the ratios of the folate/vitamin B12 and transferrin/ferritin requests were compared between AACCs. We also calculated reagent costs and the number of iron, transferrin and folate tests and the economic saving if every AACC had obtained the results achieved by the AACC with best practice.. 110 laboratories participated (59.8% of the Spanish population). More than 12 million tests were requested, resulting in reagent costs exceeding €16.5 million. The serum iron test was the most often requested, and the ferritin test was the most costly (over €7 million). Close to €4.5 million could potentially have been saved if iron, transferrin and folate had been appropriately requested (€6 million when extrapolated to the whole Spanish population).. The demand for and expenditure on anaemia chemistry tests in primary care in Spain is high, with significant regional differences between different AACCs.

Topics: Anemia; Biomarkers; Blood Chemical Analysis; Cost Savings; Cost-Benefit Analysis; Cross-Sectional Studies; Ferritins; Folic Acid; Health Care Costs; Health Services Needs and Demand; Health Services Research; Healthcare Disparities; Humans; Iron; Medical Overuse; Needs Assessment; Physicians, Primary Care; Practice Patterns, Physicians'; Predictive Value of Tests; Primary Health Care; Spain; Transferrin; Vitamin B 12

Anemia is a major public health issue despite preventive interventions. Data on non-iron nutritional deficiency anemia in hospitalized patients are limited.. This study explored the incidence, clinical features, and outcomes of hospitalized patients diagnosed with non-iron nutritional deficiency anemia at a major teaching hospital in Thailand.. Medical records of in-patient departments dated between January 2001 and June 2011 were retrospectively reviewed.. One hundred and two cases were identified, including 40 patients with vitamin B12 deficiency, 46 with folate deficiency, and 16 with other nutritional deficiency anemias; corresponding incidence rates were 0.4, 0.6, and 0.2 cases per 100,000 per year, respectively. Patients with vitamin B12 deficiency were mostly female, while patients with folate deficiency were preponderantly male. Glossitis and pancytopenia were common characteristics of vitamin B12 deficiency cases, whereas alcohol abuse and cirrhosis were more frequent in folate deficiency cases, as expected. Serum ferritin levels were relatively high across all categories. A significant proportion of anemia cases across all subgroups presented concomitantly with anorexia or poor food intake, which indicates underlying nutritional problems in these patients. Survival of patients with folate and other types of nutritional deficiency anemia was lower than for patients with vitamin B12 deficiency anemia (hazard ratio [HR] and p-values were 2.65, 0.001 and 2.35, 0.023, respectively). Hemoglobin normalization in patients with vitamin B12 deficiency anemia could be achieved by intramuscular injection and oral vitamin B12 treatment in 55.56% and 33.33% (p = 0.248), with a median response time of 9 and 86 weeks (p = 0.151), respectively.. Non-iron nutritional deficiency anemia was not common in hospitalized patients in this study. Vitamin B12 injections resulted in faster responses, but with similar efficacy compared with oral treatments. Survival of patients with vitamin B12 deficiency anemia was significantly better than that of those with folate or other types of nutritional anemia.

Topics: Anemia; Female; Folic Acid; Folic Acid Deficiency; Hemoglobins; Humans; Incidence; Male; Retrospective Studies; Thailand; Treatment Outcome; Vitamin B 12; Vitamin B 12 Deficiency

The aim of the present study was to assess the prevalence of deficiency of folate and vitamin B12 and, simultaneously, the nutrient intake adequacy of folate, vitamin B12, iron, vitamin A, vitamin C, vitamin B6 and calcium in 391 adolescent anaemic (Hb<120 g/l) schoolgirls living in the delta region of Myanmar (Burma). Dietary intakes were assessed using a 3 d estimated food record. The distribution of observed intakes calculated from the food records were adjusted for usual intakes, and the prevalence of inadequacy was estimated using the estimated average requirement cut-point method. Median (first, third quartile) serum folate and vitamin B12 concentrations were 6·5 (4·6, 8·5) nmol/l and 612·8 (443·2, 795·2) pmol/l, respectively. The prevalence of folate deficiency defined as <6·8 nmol/l was 54 %; however, vitamin B12 deficiency defined as <148 pmol/l was negligible (<1 %). The prevalence of inadequate intake of folate was high (100 %) as was the prevalence of inadequate intakes of vitamin A, vitamin C, vitamin B6 and calcium, ranging from 60 to 100 %. Red meat or poultry was rarely consumed, but fish was consumed on a daily basis. Green leafy vegetables were also consumed frequently but consumption of dairy products was uncommon. Folate deficiency was high, and the prevalence of inadequate intake of folate among other key micronutrients was relatively common in this sample of anaemic adolescent schoolgirls. Appropriate strategies such as food fortification and dietary diversification are needed to improve the micronutrient status of these young women to ensure optimal health and future reproductive success.

Topics: Adolescent; Anemia; Diet; Diet Records; Diet Surveys; Feeding Behavior; Female; Folic Acid; Folic Acid Deficiency; Humans; Myanmar; Vitamin B 12; Vitamin B 12 Deficiency

Elevated blood lead levels (BLL) and malaria carry an important burden of disease in West Africa. Both diseases might cause anemia and they might entail long-term consequences for the development and the health status of the child. Albeit the significant impact of malaria on lead levels described in Nigeria, no evaluation of the effect of elevated BLL on malaria risk has been investigated so far.. Between 2010 and 2012, blood lead levels of 203 Beninese infants from Allada, a semi-rural area 50km North from Cotonou, were assessed at 12 months of age. To assess lead levels, blood samples were analyzed by mass spectrometry. In parallel, clinical, microbiological and hematological data were collected. More precisely, hemoglobin, serum ferritin, CRP, vitamin B12, folate levels, and Plasmodium falciparum parasitemia were assessed and stool samples were also analyzed.. At 12 months, the mean BLL of infants was 7.41 μg/dL (CI: 65.2; 83), and 128 infants (63%) had elevated blood lead levels, defined by the CDC as BLL>5 μg/dL. Lead poisoning, defined as BLL>10 μg/dL, was found in 39 infants (19%). Twenty-five infants (12.5%) had a positive blood smear at 12 months and 144 infants were anemic (71%, hemoglobin<110 g/L). Elevated blood lead levels were significantly associated with reduced risk of a positive blood smear (AOR = 0.38, P-value = 0.048) and P. falciparum parasite density (beta-estimate = -1.42, P-value = 0.03) in logistic and negative binomial regression multivariate models, respectively, adjusted on clinical and environmental indicators.. Our study shows for the first time that BLL are negatively associated with malarial risk considering other risk factors. Malaria is one of the main causes of morbidity and mortality in infants under 5 years worldwide, and lead poisoning is the 6th most important contributor to the global burden of diseases measured in disability adjusted life years (DALYs) according to the Institute of Health Metrics. In conclusion, due to the high prevalence of elevated BLL, health interventions should look forward to minimize the exposure to lead to better protect the population in West Africa.

Topics: Anemia; Benin; C-Reactive Protein; Cross-Sectional Studies; Feces; Female; Ferritins; Folic Acid; Hemoglobins; Humans; Infant; Lead Poisoning; Malaria, Falciparum; Male; Mass Spectrometry; Multivariate Analysis; Plasmodium falciparum; Risk Factors; Rural Population; Vitamin B 12

Topics: Adolescent; Anemia; Bone Marrow; Bone Marrow Cells; Bone Marrow Transplantation; Female; Humans; Nitrous Oxide; Recurrence; Time Factors; Transplantation, Homologous; Treatment Outcome; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Humans; Vitamin B 12

Glycated hemoglobin (HgbA1C) is being increasingly used for the diagnosis of diabetes mellitus due to its high availability and reproducibility. Several studies have shown that HgbA1C levels may be affected by levels of hemoglobin and nutritional factors associated with anemia, such as vitamin B12 and iron deficiency. However, none included elderly subjects. The aim of the present study was to investigate these effects in the older nondiabetic population.. A retrospective cohort study design was used. The computerized database of a large health management organization was reviewed for all subjects without diabetes mellitus who underwent at least one measurement of HgbA1C and other hemoglobin parameters in 2002 at age≥65years. HgbA1C levels were correlated with hemoglobin, hematocrit, ferritin, iron, transferrin, vitamin B12, and folic acid levels.. A total of 11,352 subjects met the study criteria. Those with HgbA1C levels in the highest quintile (6.21-6.49%, 44.4-47.7mmol/mol) had significantly lower levels of hemoglobin, hematocrit, and iron than patients with HgbA1C levels in the lowest quintile (<5.4%, 36mmol/mol), but no linear correlation was found. There was no correlation of HgbA1C level with levels of ferritin, vitamin B12, and folic acid.. In elderly nondiabetic subjects, HgbA1C levels are not correlated with hemoglobin level or nutritional factors associated with anemia and may be interpreted without consideration of these factors.

Topics: Aged; Aged, 80 and over; Anemia; Female; Ferritins; Folic Acid; Glycated Hemoglobin; Hematocrit; Hemoglobins; Humans; Iron; Israel; Male; Retrospective Studies; Transferrin; Vitamin B 12

Some of recurrent aphthous stomatitis (RAS) patients had concomitant atrophic glossitis (AG). This study assessed whether RAS patients with AG (AG+/RAS patients) or without AG (AG-/RAS patients) had anemia and hematinic deficiencies and to evaluate whether RAS combined with AG or RAS itself was a significant factor causing anemia and hematinic deficiencies in AG+/RAS or AG-/RAS patients, respectively.. The mean corpuscular volume (MCV) and mean blood hemoglobin (Hb), iron, vitamin B12, and folic acid levels were measured and compared between any two of three groups of 160 AG+/RAS patients, 195 AG-/RAS patients, and 355 healthy control subjects.. Both AG+/RAS and AG-/RAS patients had significantly lower mean Hb, iron, and vitamin B12 levels as well as significantly greater frequencies of Hb, iron, vitamin B12, and folic acid deficiencies than healthy control subjects. Moreover, AG+/RAS patients had significantly lower mean Hb and serum iron level (for women only) and significantly greater frequencies of Hb and iron deficiencies than AG-/RAS patients. Of 69 anemia AG+/RAS patients, 30 (43.5%) had normocytic anemia and 23 (33.3%) had iron deficiency anemia. Of 38 anemia AG-/RAS patients, 26 (68.4%) had normocytic anemia and 5 (13.2%) had iron deficiency anemia.. We conclude that some of AG+/RAS or AG-/RAS patients do have anemia and hematinic deficiencies and AG+/RAS patients do have severer anemia statuses and iron deficiency than AG-/RAS patients. RAS combined with AG or RAS itself does play a significant role in causing anemia and hematinic deficiencies in AG+/RAS or AG-/RAS patients, respectively.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Anemia; Anemia, Iron-Deficiency; Atrophy; Case-Control Studies; Erythrocyte Indices; Female; Folic Acid; Folic Acid Deficiency; Glossitis; Hematinics; Hemoglobins; Humans; Iron; Male; Middle Aged; Recurrence; Risk Factors; Stomatitis, Aphthous; Tongue; Vitamin B 12; Vitamin B 12 Deficiency; Young Adult

Estimation of haemoglobin is the most widely used method to assess anaemia. Although direct cyanmethaemoglobin method is the recommended method for estimation of haemoglobin, but it may not be feasible under field conditions. Hence, the present study was undertaken to compare indirect cyanmethaemoglobin method against the conventional direct method for haemoglobin estimation.. Haemoglobin levels were estimated for 888 adolescent girls aged 11-18 yr residing in an urban slum in Delhi by both direct and indirect cyanmethaemoglobin methods, and the results were compared.. The mean haemoglobin levels for 888 whole blood samples estimated by direct and indirect cyanmethaemoglobin method were 116.1 ± 12.7 and 110.5 ± 12.5 g/l, respectively, with a mean difference of 5.67 g/l (95% confidence interval: 5.45 to 5.90, P<0.001); which is equivalent to 0.567 g%. The prevalence of anaemia was reported as 59.6 and 78.2 per cent by direct and indirect methods, respectively. Sensitivity and specificity of indirect cyanmethaemoglobin method were 99.2 and 56.4 per cent, respectively. Using regression analysis, prediction equation was developed for indirect haemoglobin values.. The present findings revealed that indirect cyanmethaemoglobin method overestimated the prevalence of anaemia as compared to the direct method. However, if a correction factor is applied, indirect method could be successfully used for estimating true haemoglobin level. More studies should be undertaken to establish agreement and correction factor between direct and indirect cyanmethaemoglobin methods.

Topics: Adolescent; Anemia; Child; Female; Folic Acid; Hemoglobins; Humans; India; Iron; Methemoglobin; Vitamin B 12

Anemia after Roux-en-Y gastric bypass (RYGB) has been reported in 5 to 64 % of patients. Since absorption of specific elements is reduced, proper supplementation is mandatory. The aim of this study was to investigate the frequency of anemia, its causes, and the related deficiencies during the 1st postoperative year after RYGB.. A retrospective review of our prospectively collected database was performed. A total of 486 patients who underwent RYGB in a 5-year period and completed at least 1-year follow-up were included. Daily supplements as suggested by the AACE/TOS/ASMBS guidelines were routinely prescribed. Blood count, iron profile, folic acid, and B12 measurements 1 year after surgery were reviewed.. One hundred ninety-five males and 291 females were included, with a mean age of 39.9 ± 11.6 years and a mean body mass index (BMI) of 42.4 ± 6.3 kg/m(2). Anemia 1 year after surgery was found in 19 patients (4 %), 6 males and 13 females. In seven women, it was related to iron deficiency. Two additional women had iron deficiency combined with low vitamin B12. Anemia was secondary to inflammation in two and indeterminate in two. In the six males, the cause of anemia was inflammation in three and indeterminate in three. Abnormal bleeding was found in five of these patients.. Frequency of anemia 1 year after RYGB in our population was low (4 %). Anemia non-attributable to malabsorption was frequently present (n = 9/19). Iron deficiency was found exclusively in women. The most common non-malabsorptive types of anemia were inflammation and dysfunctional uterine bleeding.

Topics: Adult; Anemia; Body Mass Index; Dietary Supplements; Feasibility Studies; Female; Folic Acid; Gastric Bypass; Humans; Iron; Iron Deficiencies; Male; Middle Aged; Obesity, Morbid; Postoperative Complications; Postoperative Period; Retrospective Studies; Vitamin B 12

To assess iron, folate and vitamin B12 status in hospitalized children aged between 6 mo to 5 y with severe acute malnutrition and its correlation with their clinico-epidemiological profile.. The study was conducted on 50 children with severe acute malnutrition. Anthropometric measurements were taken to determine their nutritional status. The demographic profile and relevant information of individual patient were collected by using structured proforma and an informed consent was taken for enrolling the children into the study. Serum ferritin, folate and vitamin B12 was estimated using electrochemiluminiscence (ECL) method.. Seventy eight percent patients had weight/height (WT/HT) Z score < -3 standard deviation (3SD), 72 % with mid upper arm circumference (MUAC) <11.5 cm and 22 % of them had edematous malnutrition. Anemia was prevalent in 47(94 %) and there was significant correlation between WT/HT < -3SD and vitamin B 12 deficiency (p = 0.015). Significantly higher number of these patients had vitamin B12 deficiency as compared to folate and iron deficiency (p = 0.0006 each).. Vitamin B12 deficiency was more common than iron and folate deficiencies in these patients with severe acute malnutrition.

Topics: Anemia; Anthropometry; Child, Preschool; Cross-Sectional Studies; Female; Folic Acid; Folic Acid Deficiency; Humans; India; Infant; Iron; Iron Deficiencies; Male; Nutritional Status; Prevalence; Severe Acute Malnutrition; Statistics as Topic; Vitamin B 12; Vitamin B 12 Deficiency

Bariatric surgery has gained wide acceptance as treatment for severe obesity and is associated with decreased overall mortality. The aims of this study were to evaluate the prevalence of anemia long term after Roux-en-Y gastric bypass (RYGB) and to search for factors predicting anemia.. All 745 patients who underwent RYGB between 1993 and 2003 at either Örebro or Uppsala University Hospital and who were living in Sweden were invited to participate by providing a fasting blood sample and completing a questionnaire about their health status. Full blood count, serum iron, transferrin, vitamin B12, and folic acid were determined.. Follow-up was completed in 431 patients (58 %) with mean age 51.3 ± 10 years. Of all patients, 27 % had anemia postoperatively and related deficiencies; iron, folic acid, and vitamin B12 were seen in 20, 12, and 2 %, respectively. There was no correlation between anemia and sex, follow-up time, 25-OH vitamin D level, and preoperative or postoperative BMI. An inverse correlation was found between anemia and regular medical checkups concerning gastric bypass surgery.. Twenty-seven percent of patients had anemia more than 10 years after RYGB. Anemia does not seem to progress with time and was less common in patients with regular medical checkups. Thus, improved long-term follow-up is needed.

Topics: Adult; Aged; Anemia; Female; Folic Acid; Gastric Bypass; Humans; Iron; Male; Middle Aged; Obesity, Morbid; Postoperative Period; Prevalence; Retrospective Studies; Sweden; Vitamin B 12; Vitamin B 12 Deficiency; Vitamin D

Topics: Anemia; Anemia, Iron-Deficiency; Dose-Response Relationship, Drug; Folic Acid; Folic Acid Deficiency; Homocysteine; Humans; Iron, Dietary; Vitamin B 12; Vitamin B 12 Deficiency

Anemia is common in inflammatory bowel disease (IBD). However, epidemiological studies of nonwestern IBD populations are limited and may be confounded by demographic, socioeconomic, and disease-related influences. This study evaluated the prevalence, risk factors, and etiology of anemia in Brazilian outpatients with IBD.. In this cross-sectional study, 100 Crohn's disease (CD) patients and 100 ulcerative colitis (UC) subjects were assessed. Anemia workup included complete blood count, ferritin, transferrin saturation, serum levels of folic acid and vitamin B12, and C-reactive protein (CRP) concentration.. The overall prevalence of anemia in IBD was 21%. There was no significant difference in the prevalence of anemia between CD subjects (24%) and UC (18%). Moderate disease activity (OR: 3.48, 95% CI, 1.95-9.64, P = 0.002) and elevated CRP levels (OR: 1.8, 95% CI, 1.04-3.11, P = 0.02) were independently associated with anemia. The most common etiologies of anemia found in both groups were iron deficiency anemia (IDA; 10% on CD and 6% on UC) followed by the anemia of chronic disease (ACD; 6% for both groups).. In Brazilian IBD outpatients, anemia is highly concurrent condition. Disease moderate activity as well as increased CRP was strongly associated with comorbid anemia. IDA and/or ACD were the most common etiologies.

Topics: Adolescent; Adult; Aged; Anemia; Blood Cell Count; Brazil; C-Reactive Protein; Female; Ferritins; Folic Acid; Humans; Inflammatory Bowel Diseases; Male; Middle Aged; Outpatients; Risk Factors; Transferrin; Vitamin B 12

Vitamin B12 (cobalamin, Cbl) deficiency can cause metabolic, hematological, and neurological abnormalities. Adequate levels of succinyl-coenzyme A (CoA) cannot be synthesized from methylmalonyl-CoA because of the decreased activity of the methylmalonyl-CoA mutase enzyme that uses Cbl as the cofactor. Succinyl-CoA synthesis deficiency leads to decreased heme synthesis and gluconeogenesis. The reason of growth retardation can be gluconeogenesis deficiency together with heme synthesis deficiency whereas the reason of the neurological abnormalities can be glycine increase in the tissue due to decreased heme synthesis. We present 7 infants diagnosed with severe nutritional Cbl deficiency and discuss the role of succinyl-CoA and glycine in the possible pathogenesis in this article. Patients brought to our clinic with a complaint of growth retardation and diagnosed with nutritional Cbl deficiency were included in the study. There were 5 females and 2 males. The mean age was 11 ± 2.30 (range 6-13) months. All patients had general muscular hypotonia and 4 had growth retardation. Neuromotor growth retardation was found in 4 of the children who had previously shown normal neuromotor development for age. The mean Cbl level was 83.8 ± 27.6 (45.6-114) pg/mL. The mean Cbl level of the mothers was 155 ± 56.6 (88-258) pg/mL. Six of the patients had anemia and 1 had thrombocytopenia. Mean corpuscular volume value was 91.5 ± 12.2 fL. Following treatment, the muscle tonus of the patients improved, the anemia and growth retardation decreased, and the lost neuromotor abilities were recovered. Severe nutritional Cbl deficiency is an important nutritional disease where complications can be prevented with early treatment. When evaluating the pathogenesis, it should be noted that nutritional Cbl deficiency is a succinyl-CoA synthesis deficiency.

Topics: 5-Methyltetrahydrofolate-Homocysteine S-Methyltransferase; Acyl Coenzyme A; Amino Acid Metabolism, Inborn Errors; Anemia; Female; Gluconeogenesis; Glycine; Growth Disorders; Hematopoiesis; Humans; Infant; Male; Mothers; Motor Skills; Muscle Hypotonia; Nervous System Diseases; Pregnancy; Pregnancy Complications; Vitamin B 12; Vitamin B 12 Deficiency

Cobalamin C (CblC) defects are inherited autosomal recessive disorders of vitamin B12 metabolism due to mutations in the MMACHC gene. Renal manifestations include thrombotic microangiopathy (TMA), acute or chronic renal failure, tubulointerstitial nephritis, and proximal renal tubular acidosis. However, reports about glomerular pathologies are scarce.. A 4-year-old boy presented with nephrotic syndrome, arterial hypertension, and chronic anemia but no signs of hemolysis. Renal biopsy showed TMA with ischemic glomerular collapse, foot process effacement, and tubulointerstitial fibrosis. Elevated serum levels of homocysteine suggested a cobalamin C disorder. This was confirmed by the identification of compound heterozygous mutations in the MMACHC gene. Initial therapy consisted of antihypertensive treatment including angiotensin converting enzyme inhibitor (ACEi) leading to blood pressure control and a significant reduction of proteinuria. After a definite diagnosis of CblC deficiency, hydroxocobalamin was introduced. Thereafter, homocysteine levels decreased, anemia resolved, and a further decline of proteinuria with normalization of serum protein levels was noted. Renal function remained stable.. Although uncommon, the clinical picture of CblC defects may be ruled by nephrotic syndrome mimicking glomerulonephritis, minimal change disease, or primary focal and segmental glomerulosclerosis. Key to a correct diagnosis is elevated serum levels of homocysteine, and a definite diagnosis can be confirmed by genetic testing.

Topics: Anemia; Angiotensin-Converting Enzyme Inhibitors; Biopsy; Carrier Proteins; Child, Preschool; Homocysteine; Humans; Hydroxocobalamin; Hypertension, Renal; Kidney; Male; Nephrotic Syndrome; Oxidoreductases; Thrombotic Microangiopathies; Vitamin B 12; Vitamin B 12 Deficiency

Iron, folate, and vitamin B12 serum levels are closely related with dietary habits and have an essential role in the healthy development of a fetus. We aimed to investigate hemoglobin, ferritin, folate, and vitamin B12 levels in preconceptional women in an area where a plant-based diet referred to as Mediterranean cuisine is commonly used.. The study population included 466 women between the ages of 18 and 45 years admitted for thalassemia screening. Sociodemographic variables and history of menometrorrhagia, pica, and dietary habits were collected. Serum vitamin B12, folate, ferritin, and hemoglobin levels were measured. Ferritin of <12µg/L, vitamin B12 of <200 pg/mL, and folate of <4 ng/mL were accepted as deficiencies. Hemoglobin level of <12 g/dL was classified as anemia.. Polymenorrhea was present in 11.7% and hypermenorrhea in 24.8% of women. Anemia was detected in 24.9% and thalassemia trait in 3.0% of women. Low ferritin levels were observed in 46.1%, vitamin B12 in 21.6%, and folate in 3.4% of women. In the group with low vitamin B12, decreased meat consumption was more prevalent (27.5% vs. 16.9%; P = 0.019).. Vitamin B12 and iron are the main micronutrients depleted in our community. This necessitates implementing a public health program for women consuming a Mediterranean diet.

Topics: Adult; Anemia; Demography; Diet, Mediterranean; Feeding Behavior; Female; Ferritins; Folic Acid; Folic Acid Deficiency; Humans; Mass Screening; Menorrhagia; Needs Assessment; Preconception Care; Prospective Studies; Socioeconomic Factors; Turkey; Vitamin B 12; Vitamin B 12 Deficiency

The objective of this study was to assess the prevalence of anemia and iron deficiency (ID) of a nationally representative sample of the Kuwait population. We also determined if anemia differed by socioeconomic status or by RBC folate and vitamins A and B12 levels. The subjects who were made up of 1830 males and females between the ages of 2 months to 86 years, were divided into the following age groups (0-5, 5-11, 12-14, 15-19, 20-49, ≥50 years). Results showed that the prevalence of anemia was 3% in adult males and 17% in females. The prevalence of ID varied according to age between 4% (≥50 years) and 21% (5-11 years) and 9% (12-14 years) and 23% (15-19 years), respectively, in males and females. The prevalence of anemia and ID was higher in females compared to males. Adults with normal ferritin level, but with low RBC folate and vitamins A and B12 levels had higher prevalence of anemia than those with normal RBC folate and vitamins A and B12 levels. This first nationally representative nutrition and health survey in Kuwait indicated that anemia and ID are prevalent and ID contributes significantly to anemia prevalence.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Anemia; Child; Child, Preschool; Erythrocytes; Folic Acid; Humans; Infant; Infant, Newborn; Iron Deficiencies; Kuwait; Middle Aged; Prevalence; Risk Factors; Social Class; Vitamin A; Vitamin B 12; Young Adult

Patient Blood Management (PBM) is the design of a personalized, multimodal multidisciplinary plan for minimizing transfusion and simultaneously achieving a positive impact on patient outcomes. The first pillar of PBM consists of optimizing the erythrocyte mass. The best chance for this step is offered by preoperative preparation. In most cases, a detailed medical history, physical examination and laboratory tests will identify the cause of anemia. A correct evaluation of parameters that assess the state and function of iron, such as ferritin levels, and the parameters that measure functional iron, such as transferrin saturation and soluble transferrin receptor levels, provide us with essential information for guiding the treatment with iron. The new blood count analyzers that measure hypochromia (% of hypochromic red blood cells and reticulocyte hemoglobin concentrations) provide us useful information for the diagnosis and follow-up of the response to iron treatment. Measuring serum folic acid and vitamin B12 levels is essential for treating deficiencies and thereby achieving better hemoglobin optimization.

Topics: Anemia; Avitaminosis; Biomarkers; Blood Banks; Blood Transfusion; Chronic Disease; Contraindications; Elective Surgical Procedures; Erythrocyte Indices; Ferritins; Folic Acid; Hematinics; Hemoglobinometry; Hemoglobins; Humans; Iron; Perioperative Care; Receptors, Transferrin; Transferrin; Vitamin B 12

Hemoglobin optimization and treatment of preoperative anemia in surgery with a moderate to high risk of surgical bleeding reduces the rate of transfusions and improves hemoglobin levels at discharge and can also improve postoperative outcomes. To this end, we need to schedule preoperative visits sufficiently in advance to treat the anemia. The treatment algorithm we propose comes with a simple checklist to determine whether we should refer the patient to a specialist or if we can treat the patient during the same visit. With the blood count test and additional tests for iron metabolism, inflammation parameter and glomerular filtration rate, we can decide whether to start the treatment with intravenous iron alone or erythropoietin with or without iron. With significant anemia, a visit after 15 days might be necessary to observe the response and supplement the treatment if required. The hemoglobin objective will depend on the type of surgery and the patient's characteristics.

Topics: Algorithms; Anemia; Blood Transfusion; Elective Surgical Procedures; Folic Acid; Hematinics; Hemoglobins; Humans; Iron; Medical Errors; Preoperative Care; Risk Factors; Unnecessary Procedures; Vitamin B 12

Low vitamin D status has been implicated in several chronic medical conditions and unfavorable health outcomes. Our goal was to investigate whether serum 25-hydroxyvitamin D (25OHD) levels are a potentially modifiable risk factor for anemia in a nationally representative cohort of community-dwelling individuals in the United States. We performed a cross-sectional study of 5456 individuals (≥17 years) from the National Health and Nutrition Examination Survey from 2001 to 2006. Locally weighted scatterplot smoothing (LOWESS) was used to graphically depict the relationship between serum 25OHD levels and the cumulative frequency of anemia. Multivariable logistic regression models were then used to assess the independent association of 25OHD levels with anemia, while controlling for age, sex, race, body mass index, chronic kidney disease, as well as serum levels of C-reactive protein, ferritin, iron, vitamin B12, and folic acid. The mean (standard error) 25OHD and hemoglobin levels in the analytic group were 23.5 (0.4) ng/mL and 14.4 (0.1) g/dL, respectively. Prevalence of anemia was 3.9%. Locally weighted scatterplot smoothing analysis demonstrated a near-linear relationship between vitamin D status and cumulative frequency of anemia up to 25OHD levels of approximately 20  ng/mL. With increasing 25OHD levels, the curve flattened out progressively. Multivariable regression analysis demonstrated an inverse association of 25OHD levels with the risk of anemia (adjusted odds ratio 0.97; 95% confidence interval 0.95-0.99 per 1  ng/mL change in 25OHD). Compared to individuals with ≥20  ng/mL, individuals with 25OHD levels <20  ng/mL were more likely to be anemic (adjusted odds ratio 1.64; 95% confidence interval 1.08-2.49). In a nationally representative sample of community-dwelling individuals in the United States, low 25OHD levels were associated with increased risk of anemia. Randomized controlled trials are needed to determine whether optimizing vitamin D status can reduce the burden of anemia in the general population.

Topics: Adult; Age Factors; Anemia; Body Mass Index; C-Reactive Protein; Cross-Sectional Studies; Female; Ferritins; Folic Acid; Humans; Iron; Male; Middle Aged; Nutrition Surveys; Risk Factors; Socioeconomic Factors; United States; Vitamin B 12; Vitamin D; Vitamin D Deficiency

While anemia occurs in 80 % to 90 % of patients with celiac disease (CD), it may be the sole manifestation of CD. The prevalence of CD in Indian patients with nutritional anemia is not known.. Adolescent and adult patients presenting with nutritional anemia were prospectively screened for CD using IgA anti-tissue transglutaminase antibody (anti-tTG Ab) followed, if positive, by upper gastrointestinal endoscopy and duodenal biopsy.. Ninety-six patients [mean ± SD age 32.1 ± 13.1 years and median duration of anemia 11 months (range 1 to 144 months)] were screened. Of these patients, 80 had iron deficiency anemia, 11 had megaloblastic anemia, and 5 had dimorphic anemia. Seventy-three patients were on hematinics and 36.4 % had received blood transfusions. Nineteen had a history of chronic diarrhea and the mean ± SD duration of diarrhea in them was 9.7 ± 35.8 months. IgA anti-tTG Ab was positive in 13 patients, of whom 12 agreed to undergo duodenal biopsy. Ten patients had villous atrophy (Marsh grade 3a in three, 3b in one, and 3c in six) and two did not. Thus, 10 patients with nutritional anemia (iron deficiency 9, vitamin B12 deficiency 1) were diagnosed to have CD. On multivariate logistic regression, age, duration of symptoms, and presence of diarrhea were found to be the predictors of CD. All the patients with CD were put on gluten-free diet and with iron and vitamin supplementations and showed a significant improvement in hemoglobin concentration.. CD screening should be included in the work up of otherwise unexplained nutritional anemia.

Topics: Adolescent; Adult; Anemia; Blood Transfusion; Celiac Disease; Diet, Gluten-Free; Female; Folic Acid; Hematinics; Humans; India; Iron; Male; Middle Aged; Prevalence; Prospective Studies; Tertiary Care Centers; Treatment Outcome; Vitamin B 12; Young Adult

Anemia is an important health concern worldwide, particularly in poor populations such as in India. The objective of this study was to determine the prevalence and predictors of anemia and iron status.. One thousand children ages 6 to 30 mo were included in a study undertaken in low- to middle-income neighborhoods in New Delhi, India. Children of Tigri and Dakshinpuri were identified through a community survey. Plasma concentrations of hemoglobin (Hb), soluble transferrin receptor (sTfR), folate, vitamin B12, and total homocysteine (tHcy) were measured. Predictors for plasma Hb concentration were identified in multiple linear regression models and considered significant if P-value <0.05.. The prevalence of anemia (Hb concentration <11 g/dL) was 69.6% (n = 696) whereas the prevalence of iron deficiency (elevated sTfR i.e., >4.7 nmol/L) was 31% (n = 309). The main predictors for Hb concentration were plasma concentrations of sTfR (standardized beta coefficient [β], -0.49; P < 0.001), folate (β, 0.15; P < 0.001), vitamin B12 (β, 0.10; P < 0.001), tHcy (β, -0.11; P < 0.001) among the biomarkers. Length-for-age Z score (β, 0.08; P = 0.002) and family income (β, 0.06; P = 0.027) also predicted Hb concentration.. Anemia was common in this population. Iron, folate, and vitamin B12 status were important predictors for plasma Hb concentration. Improving the status of these nutrients might reduce the burden of childhood anemia in India.

Topics: Anemia; Anemia, Iron-Deficiency; Biomarkers; Body Height; Child, Preschool; Female; Folic Acid; Hemoglobins; Homocysteine; Humans; Income; India; Infant; Iron; Iron Deficiencies; Male; Nutritional Status; Prevalence; Receptors, Transferrin; Vitamin B 12

Topics: Anemia; Antineoplastic Agents; Folic Acid; Humans; Iron; Neoplasms; Vitamin B 12

Studies report frequent micronutrient deficiencies after bariatric surgery, but less is known about micronutrient levels of pregnant women after bariatric surgery.. To prospectively evaluate micronutrient levels and supplement intake in pregnancy following bariatric surgery.. A multicenter prospective cohort study including women with restrictive or malabsorptive types of bariatric surgery. Nutritional deficiencies, together with supplement intake, were screened during pregnancy.. The total population included 18 women in the restrictive and 31 in the malabsorptive group. Most micronutrients were depleted and declined significantly during pregnancy. The proportion of women with low vitamin A and B-1 levels increased to respectively 58 and 17% at delivery (P = 0.005 and 0.002). The proportion of women with vitamin D deficiency decreased from 14% at trimester 1 to 6% at delivery (P = 0.030). Mild anemia was found in respectively 22 and 40% of the women at trimester 1 and delivery. In the first trimester, most women took a multivitamin (57.1%). In the second and third trimester, the majority took additional supplements (69.4 and 73.5%). No associations were found between supplement intake and micronutrient deficiencies.. Pregnant women with bariatric surgery show frequent low micronutrient levels. Supplementation partially normalizes low levels of micronutrients.

Topics: Adolescent; Adult; Anemia; Bariatric Surgery; Cholecalciferol; Cohort Studies; Dietary Supplements; Female; Folic Acid; Humans; Micronutrients; Obesity; Pregnancy; Pregnancy Complications; Pregnancy Trimester, Third; Prospective Studies; Vitamin A; Vitamin B 12; Vitamin D Deficiency; Vitamins; Young Adult

We present a case of a 50-year-old female patient with a history of depressive disorder and anaemia (attributed to menorrhagias). She was admitted to the cardiology department with symptoms of fatigue on moderate exertion for several months, with worsening in the month before hospitalisation. Echocardiography revealed a severe mitral stenosis of rheumatic aetiology. Laboratory tests showed microcytic and hypochromic anaemia, reduced iron stores and vitamin B12 levels, and positive serum antiparietal cells autoantibodies. Endoscopy showed focal areas of erythema in the stomach, corresponding histologically to chronic atrophic gastritis. In this context, two distinct clinical entities were diagnosed in the same patient: severe rheumatic mitral stenosis and autoimmune gastritis. The patient was started on vitamin B12 and iron supplementation and underwent surgical correction of the valvular disease. There was symptomatic improvement in her signs of fatigue.

Topics: Anemia; Anemia, Iron-Deficiency; Autoantibodies; Autoimmune Diseases; Echocardiography; Fatigue; Female; Gastritis, Atrophic; Humans; Iron Deficiencies; Iron, Dietary; Middle Aged; Mitral Valve; Mitral Valve Stenosis; Parietal Cells, Gastric; Rheumatic Heart Disease; Stomach; Vitamin B 12; Vitamin B 12 Deficiency

Vitamin B12 deficiency is prevalent in many countries of origin of refugees. Using a threshold of 5% above which a prevalence of low Vitamin B12 is indicative of a population health problem, we hypothesised that Vitamin B12 deficiency exceeds this threshold among newly-arrived refugees resettling in Australia, and is higher among women due to their increased risk of food insecurity. This paper reports Vitamin B12 levels in a large cohort of newly arrived refugees in five Australian states and territories.. In a cross-sectional descriptive study, we collected Vitamin B12, folate and haematological indices on all refugees (n = 916; response rate 94% of eligible population) who had been in Australia for less than one year, and attended one of the collaborating health services between July 2010 and July 2011.. 16.5% of participants had Vitamin B12 deficiency (<150 pmol/L). One-third of participants from Iran and Bhutan, and one-quarter of participants from Afghanistan had Vitamin B12 deficiency. Contrary to our hypothesis, low Vitamin B12 levels were more prevalent in males than females. A higher prevalence of low Vitamin B12 was also reported in older age groups in some countries. The sensitivity of macrocytosis in detecting Vitamin B12 deficiency was only 4.6%.. Vitamin B12 deficiency is an important population health issue in newly-arrived refugees from many countries. All newly-arrived refugees should be tested for Vitamin B12 deficiency. Ongoing research should investigate causes, treatment, and ways to mitigate food insecurity, and the contribution of such measures to enhancing the health of the refugee communities.

Topics: Adolescent; Adult; Afghanistan; Anemia; Australia; Bhutan; Child; Child, Preschool; Erythrocyte Count; Female; Humans; Infant; Infant, Newborn; Iran; Male; Middle Aged; Refugees; Vitamin B 12; Vitamin B 12 Deficiency; Young Adult

Cobalamin (Cb) blood levels are frequently measured among inpatients, but the relevance of Cb determination has not been correctly assessed in this clinical setting.. We aimed to prospectively evaluate current indications compared to traditional guidelines for assessing Cb blood levels among inpatients from internal medicine departments.. This study was conducted in French departments of internal medicine between 2008 and 2009. Inpatients who underwent Cb blood level determination during a 6-week study period were eligible.. 380 consecutive adult patients were included. The three most common indications for Cb assessment were anaemia (62.6%), cognitive impairment (20.2%) and undernutrition (17.4%). Traditional indications (ie, macrocytic non-regenerative anaemia, isolated macrocytosis, dementia and proprioceptive disorders) accounted for only 33.9% of all tests. Cb deficiency was identified in 40 (10.5%) of the 380 patients tested. Overall, traditional indications were not associated with a significantly higher prevalence of patients with low Cb levels than current guidelines (14% vs 8.8%; p=0.119). Non-regenerative macrocytic anaemia was the only indication with a significantly better performance compared to all other indications (11 of 62 patients (17.7%) vs 29 of 318 patients (9.1%); OR 2.15 (1.01-4.57), p=0.047). The main aetiological causes of Cb deficiency were intake deficiency, pernicious anaemia and food-Cb malabsorption. Homocysteine or methylmalonic acid dosage testing was very rarely performed.. Traditional indications did not perform better than other indications observed in current practice for identifying low Cb levels among inpatients from internal medicine departments. Future studies are needed to establish robust guidelines for inpatient screening.

Topics: Aged; Aged, 80 and over; Anemia; Cognition Disorders; Data Collection; Female; France; Humans; Inpatients; Internal Medicine; Male; Malnutrition; Mass Screening; Middle Aged; Prospective Studies; Vitamin B 12; Vitamin B 12 Deficiency

To study vitamin B12 concentrations in patients with type 2 diabetes with and without metformin use and to identify risk factors and consequences of low vitamin B12 concentrations.. This study had a cross-sectional design. During eight weeks all patients with type 2 diabetes visiting the diabetic outpatient clinic of the Isala Clinics in Zwolle were approached for participation. Participation included measurement of haemoglobin, mean corpuscular volume and vitamin B12 levels. Data on neuropathy were retrospectively searched for in the patient records. Vitamin B12 deficiency was defined as serum B12 concentrations <150 pmol/l.. In the total cohort (n=298), the overall prevalence of vitamin B12 concentrations <150 pml/l was 9.7% (95% CI 6.6-13.7%). In type 2 diabetes patients not taking metformin (n=134), the prevalence was 4.4% (95% CI 1.6-9.4%) compared with 14.1% in metformin users (n=164) (95% CI 9.2-20.4%; p=0.006). Each 100 mg step in metformin dose increased (OR=1.081, p=0.014), whereas PPI use lowered (OR=0.322, p=0.037) the odds of having a vitamin B12 deficiency in logistic regression. Nevertheless, metformin use did not predict the chance on having anaemia or neuropathy.. Among patients with type 2 diabetes using metformin, the prevalence of vitamin B12 deficiency is higher than compared with patients not using metformin. However, metformin use did not predict the chance of having anaemia or neuropathy.

Topics: Aged; Anemia; Cross-Sectional Studies; Diabetes Mellitus, Type 2; Erythrocyte Indices; Female; Hemoglobins; Humans; Hypoglycemic Agents; Male; Metformin; Middle Aged; Prevalence; Vitamin B 12; Vitamin B 12 Deficiency

Studies conducted in high income countries have shown that anaemia is a common medical condition among older people, but such data are scarce in Africa. The objectives of this study were to estimate the prevalence, types, risk factors and clinical correlates of anaemia in older people.. Participants were aged (≥ 50) years recruited from a general population cohort from January 2012 to January 2013. Blood samples were collected for assessing hemoglobin, serum ferritin, serum vitamin B12, serum folate, C-reactive protein, malaria infection and stool samples for assessment of hookworm infection. HIV status was assessed using an algorithm for HIV rapid testing. Questionnaires were used to collect data on sociodemographic characteristics and other risk factors for anaemia.. In total, 1449 people participated (response rate 72.3%). The overall prevalence of anaemia was 20.3 % (95% CI 18.2-22.3%), and this was higher for males (24.1%, 95% CI=20.7-27.7%) than females (17.5%, 95% CI=15.0-20.1%). In males, the prevalence of anaemia increased rapidly with age almost doubling between 50 and 65 years (p-trend<0.001). Unexplained anaemia was responsible for more than half of all cases (59.7%). Anaemia was independently associated with infections including malaria (OR 3.49, 95% CI 1.78-6.82), HIV (OR 2.17, 1.32-3.57) heavy hookworm infection (OR 3.45, 1.73-6.91), low fruit consumption (OR 1.55, 1.05-2.29) and being unmarried (OR 1.37 , 95% CI 1.01-1.89). However, the odds of anaemia were lower among older people with elevated blood pressure (OR 0.47, 95% CI 0.29-0.77).. Anaemia control programmes in Uganda should target older people and should include interventions to treat and control hookworms and educational programs on diets that enhance iron absorption. Clinicians should consider screening older people with HIV or malaria for anaemia. Further studies should be done on unexplained anaemia and serum ferritin levels that predict iron deficiency anaemia in older people.

Topics: Age Factors; Aged; Anemia; Blood Pressure; C-Reactive Protein; Cross-Sectional Studies; Female; Ferritins; Folic Acid; Hemoglobins; HIV Seropositivity; Hookworm Infections; Humans; Malaria; Male; Middle Aged; Odds Ratio; Prevalence; Risk Factors; Rural Population; Sex Factors; Uganda; Vitamin B 12

Topics: Aged; Anemia; Female; Humans; Taste Disorders; Tongue; Vitamin B 12; Vitamin B 12 Deficiency

Management of anaemic Jehovah's Witness (JW) patients, who refuse blood transfusion on religious grounds, is challenging. In the published literature, there are few cohort studies that consider causes of mortality in isolation and are lacking in their predictive power. This does not allow clinicians to monitor treatment progress of severely anaemic JW patients and adjust their risk of mortality. The study aims to develop an anaemia-related mortality risk prediction instrument.. This retrospective cohort study evaluated anaemia-related mortality risk factors of JW patients. JW patients were identified from the records of four major public hospitals in the Auckland and Midlands regions of New Zealand (North Shore, Auckland City, Middlemore and Waikato hospitals) for the period 1998 to 2007 inclusive. The inclusion criteria were age ≥15 years and severe anaemia (haemoglobin concentration ≤80 g/L). Palliative care cancer patients were excluded.. Anaemia-related risk factors of mortality for JW patients were identified, weighted and used to construct a mortality risk predictive score (the Hamilton Anaemia Mortality Risk Score (Hamilton AMRS)). This permitted stratification of JW patients into mortality risk groups according to their Hamilton AMRS. It is shown that patients with Hamilton AMRS of 0 to 2 had 4% mortality, patients with Hamilton AMRS of 3 to 4 had 29% mortality, patients with Hamilton AMRS of 5 had 40% mortality and patients with Hamilton AMRS of ≥6 had 67% mortality.. The Hamilton AMRS allows treatment monitoring of anaemic JW patients and adjustment of their risk of mortality.

Topics: Aged; Anemia; Erythropoietin; Female; Humans; Iron; Jehovah's Witnesses; Male; Middle Aged; Recombinant Proteins; Retrospective Studies; Trace Elements; Vitamin B 12; Vitamin B Complex

Postadolescent acne has been defined as the presence of acne beyond the age of 25 years. Postadolescent acne affects approximately 14% of women between the ages of 25 and 50 years. Namely, postadolescent acne usually occurs in women of reproductive age. Nutritional anemia occurs from an insufficient intake of nutrients such as iron, folate and vitamin B12. It is very common in women of reproductive age. Nutritional anemia causes irritability, apathy, fatigue, depressive symptoms and difficulty in concentration. The major etiological factor in adult acne can be increased levels of emotional stress, leading to increase in adrenal androgens. Thus, nutritional anemia may aggravate the lesions of acne by affecting the emotional status in women of reproductive age.. We aimed to investigate the relationship between postadolescent acne and nutritional anemia in this study.. The study population comprised of 52 patients with postadolescent acne and 52 healthy control subjects. Hemogram, vitamin B12, folate, serum iron, ferritin and total iron-binding capacity (TIBC) were measured.. No significant differences were observed between both groups in hemoglobin, vitamin B12, serum iron, ferritin and TIBC levels. Serum folate levels were significantly decreased in postadolescent acne patients (p < 0.001). There were no significant correlations between hemoglobin, vitamin B12, folate, serum iron, ferritin and TIBC levels and acne severity.. We could not find any relationship between postadolescent acne and nutritional anemia in our study. However, serum folate levels were decreased in postadolescent acne patients. Prospective research studies are needed to clarify the role of nutrition in the pathophysiology of postadolescent acne. We think that nutritional interventions can be inexpensive, safe, easy to administer and generally acceptable to patients with postadolescent acne.

Topics: Acne Vulgaris; Adult; Anemia; Female; Ferritins; Folic Acid; Hemoglobins; Humans; Iron; Middle Aged; Nutritional Status; Vitamin B 12

Anemia has been associated with increased physical and financial costs and occurs more frequently in older individuals. Therefore, the primary objectives of this study were to examine the prevalence and possible predictors of anemia in the very old.. Hemoglobin was used to identify those with anemia in a group of centenarians and near centenarians (98+, n = 185) and octogenarians (n = 69), who were recruited as part of the population-based multidisciplinary Georgia Centenarian Study. Blood markers, including ferritin, vitamin B12, red blood cell folate, methylmalonic acid, creatinine, and C-reactive protein, demographic variables, and medication and/or supplement usage were used to determine possible predictors of anemia.. The prevalence of anemia was 26.2% in octogenarians and 52.1% in centenarians. Low serum albumin (<3.6 g/dL) and decreased estimated glomerular filtration rate (<45 mL/min/m(2)) were predictors of anemia in centenarians.. Anemia is a major health issue, particularly as people age. Because of the high prevalence of anemia in older individuals, awareness of the predictors associated with anemia becomes increasingly important so as to reduce the negative consequences associated with it and allow for the identification of steps that can be taken to correct anemia, including managing chronic disease.

Topics: Aged, 80 and over; Anemia; C-Reactive Protein; Chronic Disease; Creatinine; Dietary Supplements; Erythrocytes; Female; Ferritins; Folic Acid; Georgia; Glomerular Filtration Rate; Hemoglobins; Humans; Male; Methylmalonic Acid; Prevalence; Serum Albumin; Vitamin B 12

Topics: Anemia; Humans; Leukemia, Myeloid, Acute; Male; Neutropenia; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Anemia; Anemia, Iron-Deficiency; Colitis, Ulcerative; Crohn Disease; Folic Acid; Folic Acid Deficiency; Inflammatory Bowel Diseases; Iron; Iron Deficiencies; Micronutrients; Vitamin B 12; Vitamin B 12 Deficiency; Vitamin B Deficiency

The aim of this retrospective cohort study was to identify early risk factors of mortality and develop a mortality risk stratification instrument for severely anaemic Jehovah's Witness patients. It has been shown that Jehovah's Witness patients with the Auckland Anaemia Mortality Risk Score (Auckland AMRS) of 0 to 3 had 4% mortality, Auckland AMRS 4 to 5 32%, Auckland AMRS 6 to 7 50% and Auckland AMRS 8 and above 83%. It is concluded that the Auckland AMRS predicts mortality of severely anaemic Jehovah's Witness patients.

Topics: Adolescent; Adult; Aged; Anemia; Cardiovascular Diseases; Erythropoietin; Factor VIIa; Female; Filgrastim; Folic Acid; Granulocyte Colony-Stimulating Factor; Hemorrhage; Hospital Mortality; Hospitals, Public; Humans; Infections; Iron; Jehovah's Witnesses; Kidney Failure, Chronic; Male; Middle Aged; New Zealand; Plasma; Postoperative Complications; Recombinant Proteins; Retrospective Studies; Risk Assessment; Risk Factors; Vitamin B 12; Young Adult

Metformin can result in vitamin B(12) deficiency, potentially leading to complications such as neuropathy. Annual monitoring of vitamin B(12) has been suggested; however, it is unknown whether current practice reflects this recommendation.. To identify vitamin B(12) monitoring patterns in patients on long-term, high-dose metformin. Secondary objective was to determine the frequency of new vitamin B(12) deficiency, anemia, and neuropathy documented after initiation of high-dose metformin.. Electronic medical records of veterans treated at the Veterans Affairs Maryland Healthcare System with high-dose metformin (≥2000 mg/day) as of November 1, 2010, were reviewed. Data regarding metformin treatment, vitamin B(12) measurements, and documentation of vitamin B(12) deficiency, cyanocobalamin supplementation, anemia, and neuropathy were collected. Subjects treated with metformin for less than 1 year or those with documented peripheral neuropathy, megaloblastic anemia, vitamin B(12) deficiency, or a condition associated with vitamin B(12) malabsorption prior to metformin initiation were excluded.. Subjects (N = 235) had a mean metformin dose of 2050 mg/day and mean duration of treatment of 5.2 years. Sixty percent did not have vitamin B(12) measured. Of subjects receiving metformin for 10 years or more, nearly half (46%) never had vitamin B(12) measured. New documentation of vitamin B(12) deficiency or cyanocobalamin supplementation was found in 5.5% of the population, and anemia was found in 12%. Of the 14% with new neuropathy, 42% did not have vitamin B(12) measured.. Vitamin B(12) was not routinely monitored in patients on high-dose metformin, even in those at highest risk (≥10 years of therapy), or in those with potential manifestations of vitamin B(12) deficiency (neuropathy). Cases of vitamin B(12) deficiency and resulting anemia or neuropathy may be undiagnosed and untreated because of lack of monitoring. Prospective studies examining the effect of increased vitamin B(12) monitoring on identification and treatment of vitamin B(12) deficiency in patients on metformin are warranted.

Topics: Anemia; Diabetes Mellitus, Type 2; Diabetic Neuropathies; Drug Monitoring; Humans; Hypoglycemic Agents; Metformin; Middle Aged; Veterans; Vitamin B 12; Vitamin B 12 Deficiency

To evaluate the prevalence of anemia and iron deficiency (ID) among patients with inflammatory bowel disease (IBD) in the Scandinavian countries.. A cross-sectional study including 429 IBD patients from six centers in Denmark, Norway and Sweden. Patients were screened for anemia and ID. Each center included ~5% of their IBD cohort. Patients were consecutively seen in the outpatient clinic, regardless of disease activity and whether the visits were scheduled or not.. The overall prevalence of anemia was 19% (95% CI: 16-23%). The prevalence was higher among patients with Crohn's disease than among patients with ulcerative colitis (p = 0.01). The etiology of anemia was as follows: iron deficiency anemia (20%), anemia of chronic disease (12%), and both conditions (68%). Less than 5% had folate acid or vitamin B12 deficiency. ID was found in 35% (CI: 31-40%) of the patients.. Anemia was present in every fifth IBD patient and ID in every third IBD patient.

Topics: Adult; Anemia; Anemia, Iron-Deficiency; C-Reactive Protein; Colitis, Ulcerative; Crohn Disease; Cross-Sectional Studies; Female; Ferritins; Folic Acid; Hemoglobins; Humans; Inflammatory Bowel Diseases; Iron; Iron Deficiencies; Male; Middle Aged; Prevalence; Scandinavian and Nordic Countries; Severity of Illness Index; Transferrin; Vitamin B 12

Topics: Aged, 80 and over; Anemia; Female; Ferritins; Folic Acid; Glomerular Filtration Rate; Hemoglobins; Humans; Kidney Diseases; Male; Malnutrition; Retrospective Studies; Sex Factors; Vitamin B 12

The present study investigates the potential ability of selenium, considered as an antioxidant with pharmacological property to alleviate oxidative stress and hematological parameter disorders induced by methimazole, an antithyroid drug. Pregnant Wistar rats were randomly divided into four groups of six each: group I served as negative control and received a standard diet; group II received 250 mg/L of methimazole in drinking water and a standard diet; group III received both methimazole (250 mg/L, orally) and selenium (0.5 mg/kg of diet) supplemented to the standard diet; group IV served as positive control and received a supplement of selenium in the diet (0.5 mg/kg of diet) as sodium selenite (Na(2)SeO(3)). Treatment was started from the 14th day of pregnancy until day 14 after delivery. Methimazole reduced the number of red blood cells, hemoglobin concentration and hematocrit in mothers and their pups. Besides, plasma iron, vitamins B(9), B(12), C and E levels were reduced. Lipid peroxidation increased, objectified by high malondialdehyde levels and lactate dehydrogenase activity in plasma, while glutathione, glutathione peroxidase, superoxide dismutase and catalase activities showed a significant decline. Co-administration of selenium through diet improved all the parameters cited above. It can be concluded that the administration of selenium alleviates methimazole-induced toxicity, thus demonstrating its antioxidant efficacy.

Topics: Anemia; Animals; Animals, Newborn; Animals, Suckling; Antioxidants; Antithyroid Agents; Ascorbic Acid; Disease Models, Animal; Female; Folic Acid; Glutathione; Hematologic Tests; Iron; Lipid Peroxidation; Male; Malondialdehyde; Methimazole; Oxidative Stress; Oxidoreductases; Pregnancy; Pregnancy Complications, Hematologic; Protective Agents; Rats; Rats, Wistar; Selenium; Vitamin B 12; Vitamin E

The role of folate in pregnancy is well established, with most prenatal vitamins (PNVs) on the market containing at least 800 μg of folic acid. Folic acid must be converted in the body to L-methylfolate, the natural and biologically active form of folate. The role of vitamin B(12) in pregnancy is less characterized, and most PNV formulations contain only 0 to 12 μg. The present study was undertaken to evaluate whether taking a prenatal medical food containing L-methylfolate and much higher doses of vitamin B(12) results in higher hemoglobin levels and thus, a lower incidence of anemia during pregnancy.. The objective of this exploratory study was to evaluate the effects of the prenatal medical food versus standard PNVs on hemoglobin levels and adverse outcomes throughout pregnancy.. For this retrospective analysis, we reviewed the charts of female patients taking either a prenatal medical food or standard PNV during pregnancy. Hemoglobin levels measured at initiation of prenatal care, end of second trimester, and delivery were recorded. Patients who had received additional iron supplementation, beyond that contained in the prenatal medical food or PNV they were taking and before anemia screening at the end of the second trimester, were excluded from the study. Fisher exact test, χ(2) test, student t test, and ANOVA were used to evaluate differences between the treatment groups.. Data were analyzed from 112 charts: 58 patients (51.8%) were taking the prenatal medical food; 54 patients (48.2%) were taking standard PNVs. Mean (SD) age at first prenatal visit was 27 (4.6) years in the medical food group and 28.8 (3.5) years in the PNV group (P = 0.024). Mean (SD) body mass indices were 29.1 (6.5) and 31.7 (8.9) in the medical food and PNV groups, respectively (P = NS). In the medical food group, 35 women (60.3%) were white/Caucasian, 17 (29.3%) were African American, and 6 (10.4%) were of other races. In the PNV group, 24 women (44.4%) were white/Caucasian, 25 (46.3%) were African American, and 5 (9.3%) were of other races. However, race was not significantly different between the two groups. At end of second trimester and at delivery, mean (SD) hemoglobin levels were higher in the prenatal medical food group (11.8 [1.1] g/dL and 11.8 [1.3] g/dL, respectively) than in the PNV group (11.3 [1.2] g/dL and 10.7 [1.2] g/dL, respectively) (P = 0.011 and P = 0.001, respectively). Significantly fewer cases of anemia were reported at end of second trimester in the prenatal medical food group than in the PNV group (39.7% vs 74.1%; P = 0.001).. In the present study, supplementation with a prenatal medical food containing L-methylfolate and high-dose vitamin B(12) may maintain hemoglobin levels and decrease rates of anemia in pregnancy more effectively than standard prenatal vitamins; however, prospective, controlled studies are warranted. ClinicalTrials.gov identifier: NCT01193192.

Topics: Adult; Anemia; Clinical Trials as Topic; Docosahexaenoic Acids; Female; Folic Acid; Food, Fortified; Hemoglobins; Humans; Incidence; Pre-Eclampsia; Pregnancy; Pregnancy Complications, Hematologic; Pregnancy Outcome; Pregnancy Trimester, Second; Prenatal Care; Retrospective Studies; Vitamin B 12; Vitamins; Young Adult

Topics: Anemia; Anemia, Megaloblastic; Biomarkers, Tumor; Diagnosis, Differential; Erythroblasts; Humans; Leukemia, Myeloid, Acute; Male; Middle Aged; Neutropenia; Severity of Illness Index; Vitamin B 12; Vitamin B 12 Deficiency

A 50-year-old man presented with a four-year history of unsteadiness, with recent falls and tingling in his fingers. Neurological examination found an ataxic gait, with a positive Romberg's sign. There was distal wasting and weakness in all four limbs and impaired co-ordination, with pseudoathetosis in the arms. Initial investigations showed a normochromic, normocytic anaemia, leucopenia, neutropenia and a low vitamin B(12) (172 ng/L). Treatment with intramuscular cobalamin injections showed no clinical improvement. Further investigations showed an undetectable caeruloplasmin (<0.085 g/L), a very low serum copper (1.1 μmol/L) and a markedly raised serum zinc concentration (36.2 μmol/L). On detailed questioning it became apparent that he had ill-fitting dentures requiring excessive use of denture fixative with high zinc content. The patient was switched to a non-zinc containing denture fixative and commenced copper supplementation. Although within three months the bone marrow suppression had resolved, there was no clinical improvement in neurological presentation. Questioning a patient about their denture fixative usage and checking if zinc is an ingredient may be considered during an investigation for myelopolyneuropathy when vitamin B(12) deficiency is not a cause.

Topics: Anemia; Ceruloplasmin; Copper; Dental Cements; Dentures; Diagnosis, Differential; Heavy Metal Poisoning; Humans; Male; Middle Aged; Neutropenia; Poisoning; Polyneuropathies; Vitamin B 12; Vitamin B 12 Deficiency; Zinc

Screening of women of child bearing age among the tribal and rural population of different north eastern and eastern states of India was performed. More than 50% of women in some areas were found to have anemia. As part of the study nutritional supplementation was given to a proportion of the anemic population, comparing the effects of Spirulina, a compound containing vitamins and micronutrients and an iron-folic acid-B12 supplement. Follow-up of the cases was done over a period of one year and the impact of supplementation and a comparison of the two compounds made.

Topics: Adolescent; Adult; Anemia; Dietary Supplements; Female; Folic Acid; Follow-Up Studies; Geography; Hemoglobins; Humans; Incidence; India; Iron, Dietary; Mass Screening; Micronutrients; Middle Aged; Outcome Assessment, Health Care; Population Groups; Pregnancy; Pregnancy Complications; Rural Population; Vitamin B 12; Vitamins; Young Adult

To determine the overall folate status of a population-based multi-ethnic sample of octogenarians and centenarians and the specific dietary, demographic and physiological factors associated with observed abnormalities.. Population-based multiethnic sample of adults aged 80 to 89 and 98 and above.. Northern Georgia, USA.. Men and women aged 80 to 89 (octogenarians, n = 77) and 98 and older (centenarians, n = 199).. Wilcoxon rank sum tests, and Chi square and logistic regression analyses were used to examine associations of low and high folate status with hematological indicators and other variables of interest.. The prevalence of low red blood cell (RBC) folate was low overall, but tended to be higher in centenarians than in octogenarians (6.5% vs. 1.3%, p = 0.058; defined as RBC folate < 317 nmol/L). The risk of having lower RBC folate (< 25th vs. > 25th percentile for RBC folate for 60yr+ in NHANES 1999-2000) was greater in association with vitamin B12 deficiency (OR = 5.36; 95%CI: 2.87-10.01), African American race (OR = 4.29; 95%CI: 2.08-8.83), and residence in a skilled nursing facility (OR = 3.25; 95%CI: 1.56-6.78) but was not influenced by age, gender, B-vitamin supplement use, high/low food score or presence of atrophic gastritis. Combined high plasma folate and low vitamin B12 status was present in some individuals (n=11), but was not associated with increased prevalence of anemia or cognitive impairment in this study.. Low RBC folate status (< 317 nmol/L) was rare in this post folic acid fortification sample of octogenarians and centenarians. RBC folate status (< 25th percentile) was strongly associated with 1) vitamin B12 deficiency, which has strong implications for vitamin treatment, and 2) with being African American, suggesting racial disparities exist even in the oldest old.

Topics: Aged, 80 and over; Anemia; Black or African American; Cohort Studies; Dietary Supplements; Erythrocytes; Female; Folic Acid; Folic Acid Deficiency; Georgia; Health Status Disparities; Humans; Male; Nutrition Surveys; Nutritional Status; Prevalence; Surveys and Questionnaires; Vitamin B 12; Vitamin B 12 Deficiency; Vitamin B Complex; White People

Topics: Anemia; Animals; Bird Diseases; Bone Marrow; Diagnosis, Differential; Disease Progression; Folic Acid; Folic Acid Deficiency; Macadamia; Male; Parrots; Vitamin B 12; Vitamin B 12 Deficiency

Vitamin B12 deficiency is a longstanding public health problem which affects more than 20% of the elderly population. Among multiple causes of vitamin B12 deficiency, Biermer's disease is currently mentioned in about 25% of the cases.. We report the case of a 71-year-old woman, taking folate substitution therapy who, over 2 years, progressively developed spinal combined sclerosis, subacute dementia and severe neuropathy leading to a bedridden state. The initial assessment revealed normocytic anemia, without vitamin B12 deficiency and without increased plasma level of biological markers. The plasma folate level was high. Vitamin B12 assay was repeated leading to the diagnosis of deficiency associated with the presence of intrinsic factor antibodies.. This observation illustrates the broad spectrum of clinical presentations of vitamin B12 deficiency. In the present case, the lack of sensitivity of biological markers delayed diagnosis and had a dramatic impact on outcome. This case highlights the importance of promoting factors such as isolated folate substitution in B12 deficient patients.

Topics: Aged; Anemia; Beds; Brain; Dementia; Diagnosis, Differential; Female; Folic Acid; Functional Laterality; Humans; Magnetic Resonance Imaging; Motor Activity; Sclerosis; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Aged; Anemia; Diabetes Mellitus, Type 2; Drug Synergism; Female; Folic Acid; Humans; Hyperhomocysteinemia; Hypoglycemic Agents; Intestinal Absorption; Male; Metformin; Middle Aged; Proton Pump Inhibitors; Retrospective Studies; Vitamin B 12; Vitamin B 12 Deficiency

The aim of this retrospective study of patients with tongue pain who showed no improvement after initial treatment and examination was to find out if their lack of response correlated with serum concentrations of zinc, vitamin B12, folic acid, and copper, and if it was associated with coexisting systemic diseases. We studied 311 patients for whom we had data about serum concentrations of these elements, and recorded whether they had any systemic diseases and were taking medicines regularly. One patient (0.3%) had a copper concentration outside the reference range; 2 patients (0.6%) had folic acid concentrations outside the reference range. The corresponding number for vitamin B12 was 5 (2%), and for zinc 30 (10%). The systemic diseases with the highest rates were: hyperlipidaemia (n=53, 17%), gastritis or gastric ulcer (n=51, 16%), angina pectoris (n=39, 13%), diabetes mellitus (n=31, 10%), thyroid disease (n=31, 10%), mild mental disorder (n=27, 9%), hypertension (n=18, 6%), cerebral infarction (n=17, 6%), leiomyoma (n=15, 5%) and anaemia (n=15, 5%). Roughly 10% of the patients were deficient in zinc. This study suggested that the serum concentration of zinc was most important to the patients with tongue pain. Many patients had more than one systemic condition, and all were taking various drugs.

Topics: Adult; Aged; Aged, 80 and over; Anemia; Angina Pectoris; Cerebral Infarction; Copper; Diabetes Complications; Female; Folic Acid; Gastritis; Glossalgia; Humans; Hyperlipidemias; Hypertension; Leiomyoma; Male; Middle Aged; Retrospective Studies; Thyroid Diseases; Vitamin B 12; Young Adult; Zinc

Topics: Aged; Anemia; Female; Folic Acid; Humans; Hyperhomocysteinemia; Hypoglycemic Agents; Intestinal Absorption; Metformin; Vitamin B 12; Vitamin B 12 Deficiency

Anemia is a common complication of human malaria. Since micronutrient deficiencies are highly prevalent in malaria-endemic areas and appear to contribute to anemia etiology, we conducted a cross-sectional study in Tumaco, Colombia, to examine the associations between plasma vitamin B12 or erythrocyte folate concentrations and hemoglobin (Hb) among 96 adults with predominantly Plasmodium falciparum malaria. Prevalence of folate and vitamin B12 deficiencies was 26.0 and 26.6%, respectively. There was an inverse, linear relation between folate and Hb concentrations. Adjusted difference in Hb between lowest and highest folate quartiles was 1g/dL (p=0.04; p, test for trend=0.01). Vitamin B12 was not associated with Hb concentrations and did not modify the associations between folate and Hb. Incidentally, body mass index (BMI) was inversely associated with parasitemia and risk of clinical malaria. Future longitudinal studies are warranted to determine the potential pathophysiological role of folate in malaria-related anemia.

Topics: Adolescent; Adult; Anemia; Animals; Colombia; Cross-Sectional Studies; Female; Folic Acid; Hemoglobins; Humans; Malaria, Falciparum; Male; Middle Aged; Parasitemia; Plasmodium falciparum; Vitamin B 12; Young Adult

While undernutrition and anaemia have previously been linked to poor development of children, relatively little is known about the role of B-vitamins and fatty acids on cognition. The present study aims to explore the associations between indicators of body size, fatty acid and micronutrient status on cognitive performance in 598 Indian school children aged 6-10 years. Baseline data of a clinical study were used to assess these associations by analyses of variance adjusting for age, sex, school, maternal education and cognitive tester. The Kaufman Assessment Battery for Children II was used to measure four cognitive domains, including fluid reasoning, short-term memory, retrieval ability and cognitive speediness. Scores were combined into an overall measure, named mental processing index (MPI). Body size indicators and Hb concentrations were significantly positively related to cognitive domains and MPI, such that increases of 1 sd in height-for-age and weight-for-age z-scores would each translate into a 0.09 sd increase in MPI, P = 0.0006 and 0.002, respectively. A 10 g/l increase in Hb concentrations would translate into a 0.08 sd increase in MPI, P = 0.0008. Log-transformed vitamin B12 concentrations were significantly inversely associated with short-term memory, retrieval ability and MPI (beta (95 % CI) = - 0.124 (- 0.224, - 0.023), P = 0.02). Other indicators of Fe, iodine, folate and fatty acid status were not significantly related to cognition. Our findings for body size, fatty acids and micronutrients were in agreement with previous observational studies. The inverse association of vitamin B12 with mental development was unexpected and needed further study.

Topics: Analysis of Variance; Anemia; Body Size; Child; Child Development; Cognition; Cross-Sectional Studies; Fatty Acids; Female; Hemoglobins; Humans; India; Male; Malnutrition; Micronutrients; Nutritional Status; Vitamin B 12

Anaemia in the very elderly is usually dissected to a variety of root causes. The frequency of nutritional anaemias is particularly uncertain, since there is controversy on the real prevalence of folate, vitamin B12 and iron deficiencies, as well as on their potential pathophysiological relationship with anaemia.. We retrospectively analysed results of haemoglobin, ferritin, folate and vitamin B12 measurements performed on a cohort of unselected subjects over 85 years old who were referred by general practitioners for routine diagnostic check-up to our laboratory over the past 2 years. Furthermore, glomerular filtration rate (GFR) was estimated using the Modification of Diet in Renal Disease (MDRD) formula.. The overall prevalence of nutritional deficiencies was low in males (<25%) and very low in females (<15%). Significant differences between anaemic and non-anaemic subjects were observed only for GFR in both males (44+/-3 versus 67+/-3 mL/min/1.73 m(2); p=0.035) and females (42+/-3 versus 61+/-3 mL/min/1.73 m(2); p=0.019). Likewise, a significantly difference in the frequency of anaemic and non-anaemic subjects with values below the conventional thresholds of the parameters tested was observed only for GFR in both males (59 versus 14%; p<0.001) and females (61 versus 41%; p<0.001), and for ferritin in females (15 versus 5%; p<0.001). In multiple linear regression analysis haemoglobin values were significantly associated only with GFR (both in men and women).. The results of this study suggest that impaired renal function might be the major determinant of anaemia in the very elderly. Accordingly, the cost-effectiveness of screening for nutritional deficiencies in older individuals is doubtful, since it would be associated with substantial expenditure and limited diagnostic efficiency.

Topics: Aged, 80 and over; Anemia; Female; Ferritins; Folic Acid; Glomerular Filtration Rate; Hemoglobins; Humans; Kidney Diseases; Male; Malnutrition; Retrospective Studies; Sex Factors; Vitamin B 12

To assess the prevalence of folate, vitamin B(12), and iron deficiencies and their associations with anemia among women of childbearing age in northern China, an area with a reported high incidence of neural tube defects.. Plasma folate, vitamin B(12), ferritin, and hemoglobin levels were measured among 1,671 non-pregnant women of childbearing age from Xianghe County, Hebei Province, China in June 2004.. Geometric means [95 % confidence interval (CI)] of plasma concentrations were 9.3 (4.0, 21.6) nmol/L for folate, 213.1 (82.4, 550.9) pmol/L for vitamin B(12), 17.4 (1.1, 278.6) microg/L for ferritin, and 129.9 (104.6, 161.4) g/L for hemoglobin (Hb). Approximately 24 % of women had biochemical evidence of folate deficiency (<6.8 nmol/L), 21.4 % were deficient (<148 pmol/L) in vitamin B(12), 30.2 % had iron depletion (<15 microg/L), and anemia (Hb < 120 g/L) was detected among 15.4 % of women. Of the three nutrients, only iron depletion (ferritin < 15 microg/L) was independently associated with anemia (adjusted odds ratio = 6.4, 95 % CI 4.8, 8.6).. Although there were substantial proportions of folate and vitamin B(12) deficiencies among women of childbearing age in northern China, iron deficiency was the most important contributor to anemia.

Topics: Adult; Anemia; Anemia, Iron-Deficiency; China; Cross-Sectional Studies; Female; Ferritins; Folic Acid; Folic Acid Deficiency; Hemoglobins; Humans; Iron; Iron Deficiencies; Odds Ratio; Prevalence; Rural Population; Vitamin B 12; Vitamin B 12 Deficiency

Anemia in older persons is commonly overlooked despite mounting evidence that low hemoglobin levels are a significant marker of physiologic decline. Using the World Health Organization definition of anemia (hemoglobin level less than 13 g per dL [130 g per L] in men and less than 12 g per dL [120 g per L] in women), more than 10 percent of persons older than 65 years are anemic. The prevalence increases with age, approaching 50 percent in chronically ill patients living in nursing homes. There is increasing evidence that even mild anemia is associated with increased morbidity and mortality. Anemia warrants evaluation in all older persons, except those at the end of life or who decline interventions. About one third of persons have anemia secondary to a nutritional deficiency, one third have anemia caused by chronic inflammation or chronic kidney disease, and one third have unexplained anemia. Nutritional anemia is effectively treated with vitamin or iron replacement. Iron deficiency anemia often is caused by gastrointestinal bleeding and requires further investigation in most patients. Anemia of chronic inflammation or chronic kidney disease may respond to treatment of the underlying disease and selective use of erythropoiesis-stimulating agents. The treatment of unexplained anemia is difficult, and there is little evidence that treatment decreases morbidity and mortality, or improves quality of life. Occasionally, anemia may be caused by less common but potentially treatable conditions, such as autoimmune hemolytic anemia, malignancy, or myelodysplastic syndrome.

Topics: Aged; Algorithms; Anemia; Deficiency Diseases; Erythrocyte Indices; Female; Ferritins; Folic Acid; Hematinics; Homocysteine; Humans; Inflammation; Iron Compounds; Male; Medical History Taking; Methylmalonic Acid; Physical Examination; Renal Insufficiency; Reticulocyte Count; Vitamin B 12

This prospective, observational study investigated the haematological response to darbepoetin alfa (DA) administered every three weeks for the treatment of anaemia. Response was also assessed according to baseline characteristics including iron, folate and vitamin B12 status.. Anaemic adult patients with malignant non-myeloid cancer, starting or having already undergone chemotherapy received DA on day of inclusionand were followed up for up to 24 weeks. Concentration of haemoglobin (Hb), as well as iron, vitamin B12 and folate status where available, were recorded at inclusion, after a treatment period of 9 weeks and up to a maximum of 24 weeks or cessation of DA treatment, whichever was sooner.. The main outcome measure assessed in this study was the percentage of patients reaching a Hb concentration of at least 11 g/dL at least once at any time during the study.. A total of 2912 patients were included. The mean Hb concentration increased from 10.0 g/dL at inclusion to 11.4 g/dL at 9 weeks and 11.8 g/dL at 24 weeks. In 74.6% of patients the target Hb level of 11.0 g/dL or above was reached. After initiation of DA treatment, 9.5% of patients required a blood transfusion by week 9, and 5.6% thereafter. Vitamin B12 and folate status were unknown for 80.3% of patients and the iron status for 73.2% of patients. Compared with patients who remained untreated for vitamin B12 or folate deficiency, a higher percentage of patients with vitamin status within normal limits achieved the target Hb concentration. However, achievement of target Hb level appeared not to be affected by iron status.. In this study, the mean Hb level increased in anaemic cancer patients treated with DA and the majority of patients achieved the target Hb level. In contrast to the recommendations of guidelines (EORTC) encouraging the measurement of iron and vitamin levels, the present study demonstrated that data were not routinely collected for these factors.

Topics: Aged; Anemia; Antineoplastic Agents; Cohort Studies; Darbepoetin alfa; Dietary Supplements; Erythropoietin; Female; Folic Acid; France; Hematinics; Humans; Iron; Male; Middle Aged; Neoplasm Metastasis; Neoplasms; Prospective Studies; Vitamin B 12

Anaemia represents a common complication of inflammatory bowel disease (IBD). Most studies on anaemia in IBD patients have been performed in tertiary referral centres (RC) and data from gastroenterologic practices (GP) are lacking. We investigated the frequency and severity of anaemia in IBD patients from tertiary referral centres and gastroenterologic practices compared to the general population.. Data were acquired from patients included in the Swiss IBD Cohort Study. IBD activity was evaluated by CDAI and modified Truelove and Witts severity index (MTWSI). Anaemia was defined as haemoglobin ≤120g/L in women and ≤130g/L in men.. 125 patients from RC (66 with Crohn's disease (CD) and 59 with ulcerative colitis (UC)) and 116 patients from GP (71 CD and 45 UC) were included and compared to 6074 blood donors. Anaemia was found in 21.2% (51/241) of the IBD patients and more frequently in patients from RC as compared to GP and healthy controls (28.8% vs. 12.9% vs. 3.4%; P<0.01). IBD patients from RC suffered more frequently from active disease compared to IBD patients in GP (36% vs. 23%, P=0.032). Supplementation therapy (iron, vitamin B12, folic acid) was performed in 40% of anaemic IBD patients in GP as compared to 43% in RC.. Anaemia is a common complication in patients with IBD and significantly more prevalent in patients from referral centres as compared to patients from gastroenterologic practices. Physicians treating IBD patients should pay attention to the presence of anaemia and ensure sufficient supplementation therapy.

Topics: Adult; Anemia; Anemia, Iron-Deficiency; Colitis, Ulcerative; Crohn Disease; Cross-Sectional Studies; Dietary Supplements; Erythrocyte Indices; Female; Ferritins; Folic Acid; Hospitals, University; Humans; Inflammatory Bowel Diseases; Iron; Male; Middle Aged; Prevalence; Private Practice; Prospective Studies; Severity of Illness Index; Sex Distribution; Switzerland; Vitamin B 12

While the majority of cases of nutritional anemia in developing countries are caused by iron deficiency, other micronutrient deficiencies may also be involved. In Colombia, it was recently reported that 38% of school children were anemic; yet, the rate of iron deficiency was only 3.6%.. To determine if micronutrients other than iron were responsible for low hemoglobin concentrations in Colombian school children.. We examined hemoglobin concentrations in relation to plasma ferritin, vitamin A, vitamin B12, and erythrocyte folate levels in a representative sample of 2812 low- and middle-income children (5-12 years) from Bogotá, Colombia.. In multivariate analysis, hemoglobin concentration was positively associated with child's age, mother's age, household's socioeconomic stratum, and family income. Low ferritin was related to 3.6 g/l lower hemoglobin concentration (95% confidence interval=-6.0, -1.3). Unexpectedly, we found an inverse trend in hemoglobin concentration by quartiles of erythrocyte folate; the adjusted hemoglobin concentration difference between the highest and lowest folate quartiles was -6.0 g/l (95% confidence interval=-7.2, -4.9; P for trend <0.0001). This difference was greatest among children with vitamin B12 concentration <148 pmol/l (-11.5 g/l), followed by children with vitamin B12 concentration 148-221 pmol/l (-7.7 g/l), and smallest in children with vitamin B12 concentration >221 pmol/l (-5.7 g/l); P for interaction=0.04.. Hemoglobin concentration is inversely related to erythrocyte folate concentrations in a setting where folate fortification was adopted more than a decade ago. The impact of improving vitamin B12 status on this inverse relationship should be examined.

Topics: Anemia; Child; Child, Preschool; Colombia; Cross-Sectional Studies; Erythrocytes; Female; Ferritins; Folic Acid; Hemoglobins; Humans; Male; Vitamin A; Vitamin B 12

Topics: Aged; Anemia; Anemia, Megaloblastic; Cytokinesis; Fibroblasts; Humans; Male; Vitamin B 12

We conducted a study to determine the role of iron, folate and vitamin B12 in HIV-infected patients with anaemia attending a tertiary-care hospital in southern Brazil. Low serum folate levels were found in 14 (41%) HIV-infected patients; parameters of iron deficiency such as low transferring saturation index and ferritin in 10 (30%); and combined folate and iron deficiency in five (14%). Vitamin B12 deficiency was found in only two (6%) patients who presented with mean corpuscular volumes within the normal range. Our study has shown that folate and iron deficiency were frequently detected in HIV-infected patients at our institution, and should be considered in the differential diagnosis of anaemia in all HIV-infected patients independent of their HIV stage of progression.

Topics: Adult; Anemia; Brazil; Cross-Sectional Studies; Erythrocyte Indices; Female; Folic Acid; HIV Infections; HIV-1; Hospitals, Teaching; Humans; Iron; Male; Middle Aged; Pregnancy; Surveys and Questionnaires; Vitamin B 12; Young Adult

Topics: Age Distribution; Aged; Aged, 80 and over; Anemia; Cohort Studies; Female; Folic Acid; Geriatric Assessment; Humans; Incidence; Linear Models; Male; Multivariate Analysis; Prognosis; Retrospective Studies; Risk Assessment; Severity of Illness Index; Sex Distribution; Vitamin B 12

Topics: Age Factors; Aged, 80 and over; Aging; Anemia; Humans; Prevalence; Prognosis; Risk Factors; Vitamin B 12; Vitamin B 12 Deficiency

Medical records of 16 cats diagnosed with exocrine pancreatic insufficiency (EPI) were reviewed. The diagnosis was confirmed with either a serum feline trypsin-like immunoreactivity (fTLI) concentration

Topics: Anemia; Animals; Cat Diseases; Cats; Diarrhea; Exocrine Pancreatic Insufficiency; Female; Lymphopenia; Male; Treatment Outcome; Vitamin B 12; Weight Loss

Anemia is a common cause of morbidity and disease and reduces the quality of life. This study examined the effect of a combination treatment (AAC) using Astragali radix (AMW) and Angelicae radix (AGW) in cyclophosphamide (CYP)-induced anemic rats on erythropoietin (EPO) expression and hematological parameters. Male 4-week-old Sprague-Dawley rats were divided into five groups with or without CYP-induced anemia and individual or the combined herbal treatments according to the experimental protocol. After treatment, reverse transcription-polymerase chain reaction was used to evaluate the effects of AAC on erythropoietin expression, and blood and serological parameters were measured. The EPO mRNA levels were lower in the CYP-treated group, compared to the normal group, and higher in the AAC-treated group. In the CYP-treated group, the serum iron concentration, total iron-binding capacity, and vitamin B(12) level were lower, but these were normal or almost normal in the AAC-treated group. The CYP-treated group gained less weight than the normal group, but weight gain was partially normalized in the AAC group. The feed efficiency ratio was lowest in the CYP group, but the differences were not significant. The numbers of red blood cells, white blood cells, and platelets, the hematocrit, and the hemoglobin level were measured. The results revealed a reduced number of blood cells in the CYP-treated group, whereas the AAC-, AMW-, and AGW-treated groups showed significantly enhanced blood cell numbers compared to the CYP-treated control group and the AAC-treated group. AAC enhanced EPO mRNA expression in the CYP-induced anemic rat and improved the hematological parameters and vitamin B(12) status.

Topics: Anemia; Angelica; Animals; Antineoplastic Agents, Alkylating; Astragalus propinquus; Blood Cell Count; Blood Cells; Cyclophosphamide; Drug Therapy, Combination; Drugs, Chinese Herbal; Energy Intake; Erythropoietin; Gene Expression; Iron; Male; Phytotherapy; Plant Roots; Rats; Rats, Sprague-Dawley; RNA, Messenger; Vitamin B 12; Weight Gain

Topics: Anemia; Heart Failure; Humans; Iron, Dietary; Nutritional Status; Risk Assessment; Risk Factors; Vitamin B 12

Topics: Anemia; Cardiovascular Diseases; Female; Folic Acid; Folic Acid Deficiency; Humans; Hyperhomocysteinemia; Nutritional Status; Pregnancy; Pregnancy Outcome; Public Health; Vitamin B 12; Vitamin B 12 Deficiency; World Health Organization

Accurate assessment of maternal micronutrient status is critical to the prevention of suboptimal micronutrient status and anaemia during pregnancy. Measurement of Fe, folate and vitamin B12 status is complicated by adaptive changes to maternal and placental physiology that markedly affect concentrations of circulating micronutrients and their functional biomarkers. Validation of new assessment methods by comparison with gold standards is often prevented by ethical considerations. Antenatal screening in the UK is predominantly concerned with the detection of anaemia, although estimation of maternal Fe stores by serum ferritin at the start of antenatal care may be a more effective preventive strategy. Functional assessment of maternal anaemia is highly problematic, so instead reference data are used for its definition. The effect of mild-to-moderate anaemia on pregnancy outcome is unclear because of the crude nature of its assessment and the influence of confounding factors. Fe-deficient erythropoiesis may be detected by assessment of erythrocyte Zn protoporphyrin and reticulocyte Hb, although such measures may be unavailable in many clinical laboratories. Serum soluble transferrin receptor is highly responsive to tissue Fe deficiency and is less affected by inflammation than most other indicators. Direct inter-assay comparison of serum and erythrocyte folate values is inadvisable since recovery rates differ greatly between methods. Serum total homocysteine is a useful functional biomarker of both folate and vitamin B12 status but during pregnancy is influenced by other factors that reduce its sensitivity. Isotope-dilution liquid chromatography-tandem MS and serum holo-transcobalamin provide new opportunities to gain detailed data of folate species and vitamin B12 fractions in large samples.

Topics: Anemia; Erythropoiesis; Female; Folic Acid; Humans; Iron; Micronutrients; Nutritional Status; Pregnancy; Pregnancy Complications; Vitamin B 12

Screening for deficiencies in vitamin B(12) and folate is advocated to prevent anemia in very elderly individuals. However, the effects of vitamin B(12) and folate deficiency on the development of anemia in old age have not yet been established.. The current study is embedded in the Leiden 85-Plus Study, a population-based prospective study of subjects aged 85 years. Levels of vitamin B(12), folate, and homocysteine were determined at baseline. Hemoglobin levels and mean corpuscular volume (MCV) were determined annually during 5 years of follow-up.. We analyzed data from 423 subjects who did not use any form of cyanocobalamin, hydroxocobalamin, or folic acid supplementation, neither at baseline nor during follow-up. Folate deficiency (<7 nmol/L; n = 34) and elevated homocysteine levels (>13.5 mumol/L; n = 194) were associated with anemia at baseline (adjusted odds ratio [OR], 2.44; 95% confidence interval [CI], 1.06-5.61; and adjusted OR, 1.82; 95% CI, 1.08-3.06, respectively), but vitamin B(12) deficiency (<150 pmol/L; n = 68) was not (adjusted OR, 1.51; 95% CI, 0.79-2.87). Furthermore, vitamin B(12) deficiency was not associated with the development of anemia during follow-up (adjusted HR, 0.92; 95% CI, 0.46-1.82) or with changes in MCV (adjusted linear mixed model; P = .77). Both folate deficiency and elevated homocysteine levels were associated with the development of anemia from age 85 years onward (adjusted HR, 3.33; 95% CI, 1.55-7.14; and adjusted HR, 1.70; 95% CI, 1.01-2.88, respectively), but not with an increase in MCV over time (P > .30).. In the general population of very elderly individuals, anemia in 85-year-old subjects is associated with folate deficiency and elevated homocysteine levels but not with vitamin B(12) deficiency.

Topics: Aged, 80 and over; Anemia; Cross-Sectional Studies; Erythrocyte Indices; Female; Folic Acid; Folic Acid Deficiency; Follow-Up Studies; Hemoglobins; Homocysteine; Humans; Male; Prospective Studies; Vitamin B 12; Vitamin B 12 Deficiency

The etiology of anemia during pregnancy in rural Southern Ethiopia is uncertain. Intakes of animal-source foods are low and infections and bacterial overgrowth probably coexist. We therefore measured the dietary intakes of a convenience sample of Sidama women in late pregnancy who consumed either maize (n = 68) or fermented enset (Enset ventricosum) (n = 31) as their major energy source. Blood samples were analyzed for a complete blood count, vitamin B-12 and folate status, plasma ferritin, retinol, zinc, albumin, and C-reactive protein (CRP). The role of infection and gravida was also examined. Dietary intakes were calculated from 1-d weighed records. No cellular animal products were consumed. Of the women, 29% had anemia, 13% had iron deficiency anemia, 33% had depleted iron stores, and 74 and 27% had low plasma zinc and retinol, respectively. Only 2% had low plasma folate (< 6.8 nmol/L) and 23% had low plasma vitamin B-12 (< 150 pmol/L), even though 62% had elevated plasma methylmalonic acid (MMA) (> 271 nmol/L). None had elevated plasma cystathionine or total homocysteine (tHcys). Women with enset-based diets had higher (P = 0.052) plasma vitamin B-12 concentration and lower (P < 0.05) cell volume, plasma cystathionine, and retinol than women consuming maize-based diets, but mean hemoglobin, plasma ferritin, MMA, tHcys, and folate did not differ. Plasma zinc, followed by CRP (< or = 5 mg/L), gravida (< or = 4), and plasma ferritin (> or = 12 microg/L) status were major positive predictors of hemoglobin. Despite some early functional vitamin B-12 deficiency, there was no macrocytic anemia. Consumption of fermented enset may have increased vitamin B-12 levels in diet and plasma.

Topics: Anemia; Diet; Energy Intake; Ethiopia; Female; Folic Acid; Hemoglobins; Humans; Iron; Parity; Pregnancy; Pregnancy Complications, Infectious; Vitamin B 12; Zea mays; Zinc

Historic reports on the treatment of pernicious anemia with folic acid suggest that high-level folic acid fortification delays the diagnosis of or exacerbates the effects of vitamin B-12 deficiency, which affects many seniors. This idea is controversial, however, because observational data are few and inconclusive. Furthermore, experimental investigation is unethical.. We examined the relations between serum folate and vitamin B-12 status relative to anemia, macrocytosis, and cognitive impairment (ie, Digit Symbol-Coding score < 34) in senior participants in the 1999-2002 US National Health and Nutrition Examination Survey.. The subjects had normal serum creatinine concentrations and reported no history of stroke, alcoholism, recent anemia therapy, or diseases of the liver, thyroid, or coronary arteries (n = 1459). We defined low vitamin B-12 status as a serum vitamin B-12 concentration < 148 pmol/L or a serum methylmalonic acid concentration > 210 nmol/L-the maximum of the reference range for serum vitamin B-12-replete participants with normal creatinine.. After control for demographic characteristics, cancer, smoking, alcohol intake, serum ferritin, and serum creatinine, low versus normal vitamin B-12 status was associated with anemia [odds ratio (OR): 2.7; 95% CI: 1.7, 4.2], macrocytosis (OR: 1.8; 95% CI: 1.01, 3.3), and cognitive impairment (OR: 2.5; 95% CI: 1.6, 3.8). In the group with a low vitamin B-12 status, serum folate > 59 nmol/L (80th percentile), as opposed to < or = 59 nmol/L, was associated with anemia (OR: 3.1; 95% CI: 1.5, 6.6) and cognitive impairment (OR: 2.6; 95% CI: 1.1, 6.1). In the normal vitamin B-12 group, ORs relating high versus normal serum folate to these outcomes were < 1.0 (P(interaction) < 0.05), but significantly < 1.0 only for cognitive impairment (0.4; 95% CI: 0.2, 0.9).. In seniors with low vitamin B-12 status, high serum folate was associated with anemia and cognitive impairment. When vitamin B-12 status was normal, however, high serum folate was associated with protection against cognitive impairment.

Topics: Aged; Aging; Anemia; Anemia, Macrocytic; Cognition Disorders; Confidence Intervals; Creatinine; Female; Folic Acid; Food, Fortified; Humans; Male; Nutrition Surveys; Nutritional Status; Odds Ratio; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Aged; Anemia; Australia; Dietary Supplements; Female; Folic Acid; Folic Acid Deficiency; Humans; Middle Aged; Prevalence; Vitamin B 12; Vitamin B 12 Deficiency; Vitamin B Complex

Although anemia is a common complication after renal transplantation (RT), data concerning endogenous erythropoietin (EPO) levels in long-term RT recipients are rare. The goal of this study was to evaluate the prevalence of anemia within 6 months to 5 years after RT and to assess the relationship between the serum concentrations of endogenous EPO, graft function and grade of improvement of anemia.. 140 patients who had undergone RT were included in the group: 89 males (63.6%) and 51 females (36.4%), with an average age 46.8 +/- 12.8 years. The serum concentrations of EPO and creatinine (Cr) were tested in all the individuals and the values of the red blood component of blood count, serum ferritin (SF), plasma iron concentration, plasma total iron-binding capacity (TIBC), transferrin saturation (TS), folic acid and vitamin B(12) levels in the serum were determined. A statistical analysis of the results was performed using the correlation analysis, Mann-Whitney U test and Duncan's multiple range test.. Normal blood count values were found in 91 patients (65%), and a mild grade of anemia with a mean hemoglobin (Hb) 114.4 +/- 11.9 g/l was observed in 45 patients (32.1%), and 4 patients (2.9%) fulfilled the diagnostic criteria for post-transplantation erythrocytosis. Individuals with normal Hb values had a mean EPO serum concentration of 39.3 +/- 12.3 mU/ml (median 37.2) and the mean Cr was 133.8 +/- 36.9 micromol/l (median 122). Patients with anemia (Hb <120 g/l in females, Hb <130 g/l in males) had a mean EPO value of 47.0 +/- 26.6 mU/ml (median 36.0) and a mean Cr of 203.8 +/- 108.9 micromol/l (median 181). The difference in the Cr values was statistically significant (p < 0.0001), while the difference between the EPO concentrations was not significant. No relation of EPO serum concentration with regard to graft function was found in the analysis. A lack of storage iron (SF <10 microg/l in females, SF <22 microg/l in males) was found in 16 patients (11.4%), and a lack of functional iron (TS <20%) was found in 27 patients (19.3%).. Theprevalence of anemia in patients after transplantation was 32.1%. The most common cause of anemia is insufficient graft function development. The achieved values of the red component of blood count have no relation to the endogenous EPO serum concentrations.

Topics: Adult; Aged; Anemia; Cross-Sectional Studies; Erythropoietin; Female; Ferritins; Folic Acid; Humans; Kidney; Kidney Transplantation; Longitudinal Studies; Male; Middle Aged; Prevalence; Vitamin B 12

To determine the prevalence of hematinic deficiencies in patients with recurrent aphthous stomatitis.. The study took place in the Oral Medicine Clinic of the Jordan University Hospital in Amman, Jordan, between January 1993 and December 2000. We studied the hemoglobin, serum ferritin, vitamin B12 and folate levels in 143 patients with recurrent aphthous stomatitis. We compared the results with a control group of 143 age- and gender-matched patients with a range of other oral diseases.. In recurrent aphthous stomatitis patients, 14% were anemic and 37.8% showed hematinic deficiencies; 16.8% showed low serum ferritin; 26.6% showed low serum vitamin B12 and 4.9% showed low serum folate. In the control group, 10.5% were anemic and 18.2% showed hematinic deficiencies; 9.8% showed low serum ferritin; 12.6% showed low serum vitamin B12 and none showed serum folate deficiency.. Patients with recurrent aphthous stomatitis have more hematinic deficiencies, particularly vitamin B12 deficiency, compared with controls. Correction of these hematinic deficiencies could help in the management of the disease.

Topics: Adolescent; Adult; Aged; Anemia; Case-Control Studies; Female; Ferritins; Folic Acid; Hemoglobins; Humans; Jordan; Male; Middle Aged; Recurrence; Stomatitis, Aphthous; Vitamin B 12

To explore the levels of serum vitamin B(12) (VB(12)) in preschool children, determine the relationship between the levels of serum VB(12) and anemia, and analyze the effects of several factors related to the level of serum VB(12).. From March 2005 to July 2005, the weight, height and complete blood count (CBC) were studied in 351 children aged 2 to 7 years from 4 kindergartens of Chongqing. The concentrations of serum VB(12) and the dietary survey of 177 of the children were evaluated.. The average level of serum VB(12) for the preschool children was 552 pg/ml. The levels of serum VB(12) in 4.5% (8/177) of the children were below 200 pg/ml (defined as VB(12) deficiency), in 10.7% (19/177) of the children were 200 - 300 pg/ml (called marginal deficiency). There were no significant differences in the levels of serum VB(12) between boys and girls. And there was no correlation between the levels of serum VB(12) and hemoglobin. The results of multivariate stepwise regression analysis showed that the concentrations of serum VB(12) were mainly influenced by the contents of VB(12) in the foods (P = 0.03). Eight of the children with normal growth and development were diagnosed as VB(12) deficiency, only one of them was diagnosed microcytic hypochromatic anemia. The ranges of Hb, MCV and MHC were normal in the other 7 children.. The levels of serum VB(12) of preschool children were higher than that of adults, suggesting that the levels of serum VB(12) change with age. There were no significant differences in the levels of serum VB(12) in 2-7 years old children between sex and ages. The levels of serum VB(12) were not correlated with the concentrations of hemoglobin. Macrocytic anemia may not occur in preschool children with VB(12) deficiency. The intake of VB(12) from the diets was one of the important factors for preschool children to keep the normal ranges of serum VB(12). It is beneficial for children to consume foods enriched with VB(12) to keep the normal level of serum VB(12).

Topics: Adult; Age Factors; Anemia; Child; Child Nutritional Physiological Phenomena; Child, Preschool; China; Diet Surveys; Female; Humans; Male; Multivariate Analysis; Nutritional Status; Regression Analysis; Risk Factors; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Anemia; Breast Feeding; Diet, Vegetarian; Failure to Thrive; Humans; Infant; Infant Nutritional Physiological Phenomena; Male; Vitamin B 12; Vitamin B 12 Deficiency; Vitamin D

cblC disease is a cause of hemolytic uremic syndrome (HUS), which has been primarily described in neonates and infants with severe renal and neurological lesions.. Two sisters aged 6 and 8.5 years presented with a latent hemolytic process characterized by undetectable or low plasma haptoglobin, respectively, associated with renal failure and gross proteinuria. Renal biopsies performed in both patients found typical findings of thrombotic microangiopathy suggesting the diagnosis of HUS. Both patients were free of neurologic signs.. Biochemical investigations found a cobalamin processing deficiency of the cblC type. Search for additional factors susceptible to worsen endothelial damage revealed homozygosity 677C--> T mutation in the methylenetetrahydrofolate reductase gene as well as heterozygosity for a 3254T--> C mutation in factor H in the patient with the most severe clinical presentation. Long-term subcutaneous administration of hydroxocobalamin in combination with oral betaine and folic acid resulted in clinical and biological improvement in both patients.. cblC disease may be a cause of chronic HUS with delayed onset in childhood. Superimposed mutation of factor H gene might influence clinical severity.

Topics: Anemia; Betaine; Child; Combined Modality Therapy; Complement Factor H; Drug Therapy, Combination; Endothelium, Vascular; Female; Folic Acid; Genetic Predisposition to Disease; Genotype; Haptoglobins; Hemolytic-Uremic Syndrome; Humans; Hydroxocobalamin; Hypertension; Kidney; Methylenetetrahydrofolate Reductase (NADPH2); Mutation, Missense; Nephrotic Syndrome; Plasma Exchange; Point Mutation; Proteinuria; Proto-Oncogene Proteins; Proto-Oncogene Proteins c-cbl; Renal Dialysis; Vitamin B 12

Although anemia is frequent in inflammatory rheumatic diseases, data regarding vitamin B12 status is scarce. The purpose of this study was to analyze the incidence and nature of B12 and folic acid (FA) deficiencies in a cohort of rheumatic patients with rheumatoid arthritis (RA), psoriatic arthritis (PsA), and systemic lupus erythematosus (SLE).. Levels of B12, FA, and parameters of anemia were recovered or examined in 276 outpatients. In those with recent findings of low serum B12 levels, further studies of serum homocysteine (Hcy) and urine methylmalonic acid (MMA) levels were performed.. The incidence of anemia was high: 49%, 46%, and 35%, in RA, SLE, and PsA, respectively. Low levels of serum B12 were also frequent (24%), with almost similar occurrence in the three disease groups. Deficiency in FA was rare (<5%). Mean levels of both vitamins did not differ significantly among the three groups. No correlation between serum B12 levels and anemia was found. In the 15 patients with recently detected low B12 levels, Hcy and MMA were evaluated before and following B12 therapy. In ten of them, baseline Hcy levels were high, while MMA was increased in one patient only. Response to B12 administration, i.e., a decrease in Hcy and/or MMA levels, was noticed in four patients only, suggesting that only 26% of the low-serum-B12 patients had true B12 deficiency.. The incidences of anemia and decreased serum B12 levels were high in these three groups of rheumatic patients. However, true tissue deficiency seems to be much rarer.

Topics: Adult; Aged; Aged, 80 and over; Anemia; Arthritis, Psoriatic; Arthritis, Rheumatoid; Cohort Studies; Female; Folic Acid Deficiency; Homocysteine; Humans; Incidence; Israel; Lupus Erythematosus, Systemic; Male; Methylmalonic Acid; Middle Aged; Retrospective Studies; Treatment Outcome; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Anemia; Ceruloplasmin; Copper; Female; Follow-Up Studies; Hematologic Diseases; Humans; Magnetic Resonance Imaging; Metabolic Diseases; Middle Aged; Nervous System Diseases; Neural Conduction; Neutropenia; Peripheral Nerves; Spinal Cord; Vitamin B 12; Zinc

Anemia in chronic heart failure (CHF) is common, varying in prevalence between 14.4% and 55%, and is more frequent in patients with more severe heart failure. Patients with CHF who have anemia have a poorer quality of life, higher hospital admission rates, and reduced exercise tolerance. We explored the relation between hematinic levels and hemoglobin (Hb) levels and exercise tolerance in a group of patients with CHF.. We analyzed data from 173 patients with left ventricular systolic dysfunction (LVSD), 123 patients with symptoms of heart failure, but preserved left ventricular (LV) systolic function ("diastolic dysfunction"), and 58 control subjects of similar age. Each underwent echocardiography, a 6-minute walk test, and blood tests for renal function and Hb and hematinic levels (vitamin B12, iron, and folate). We classified patients as having no anemia (Hb level >12.5 g/dL), mild anemia (Hb level from 11.5-12.5 g/dL), or moderate anemia (Hb level <11.5 g/dL).. Of patients with LVSD, 16% had moderate anemia and 19% had mild anemia. Of patients with preserved LV function, 16% had moderate anemia and 17% had mild anemia. Four control subjects had a Hb level <12.5 g/dL. Of all patients, 6% were vitamin B12 deficient, 13% were iron deficient, and 8% were folate deficient. There was no difference between patients with LVSD and the diastolic dysfunction group. In patients with LVSDS, the average Hb level was lower in New York Heart Association class III than classes II and I. The distance walked in 6 minutes correlated with Hb level in both groups of patients with CHF (r = 0.29; P <.0001). Patients with anemia achieved a lower pVO2 (15.0 [2.3] vs 19.5 [4.4], P <.05). Peak oxygen consumption correlated with Hb level (r = 0.21, P <.05) in the patients, but not in the control subjects. In patients with anemia, the mean creatinine level was higher than in patients with a Hb level >12.5 g/dL, but there was no clear relationship with simple regression. Hematocrit level and mean corpuscular volume were not different in the patients with diastolic dysfunction, patients with LV dysfunction, or the control subjects. Hematocrit levels were not influenced by diuretic dose. Patients with anemia were not more likely to be hematinic deficient than patients without anemia.. Patients with symptoms and signs of CHF have a high prevalence of anemia (34%) whether they have LV dysfunction or diastolic dysfunction, but few patients have hematinic deficiency. Hemoglobin levels correlate with subjective and objective measures of severity and renal function.

Topics: Aged; Anemia; Anemia, Iron-Deficiency; Case-Control Studies; Chronic Disease; Creatinine; Exercise Test; Female; Ferritins; Folic Acid; Folic Acid Deficiency; Heart Failure; Humans; Iron; Male; Oxygen Consumption; Ventricular Dysfunction, Left; Vitamin B 12; Vitamin B 12 Deficiency

Iron-deficiency or anemia in pregnancy is a major public health problem in China. This cross-sectional study was carried out to observe the association between iron status and multiple vitamin levels of Chinese pregnant women in the third trimester. We measured iron, ascorbic acid, retinol, folate and vitamin B12 in serum, and riboflavin in urine specimens of 1,163 pregnant women in four sites throughout rural and city areas in China. Based on hemoglobin concentrations (Hb), the subjects were divided into an anemia group with Hb < 110 g/L or Hb < or = 100 g/L as severe anemia group, and nonanemia group with Hb > or = 110 g/L. Results showed that 41.58% of the population with serum iron < 700 microg/L and 51.04% of the population with ferritin < 12 microg/L in the anemia group, percentages that were much higher than those in the nonanemia group. Relationships between five vitamins and hemoglobin concentrations of all subjects were observed. There was a lower level of serum ascorbic acid (291.05 microg/dL) in the Hb < or = 100 g/L group than in the Hb > or = 120 g/L group (487.79 microg/dL) (p < 0.001). Serum levels of vitamin B12 and folate were 445.67 pg/mL and 5.94 ng/mL in the Hb < or = 100 g/L group, whose levels were much lower than the levels of 502.01 pg/mL (p < 0.012) and 8.07 ng/mL (p < 0.010) respectively in the Hb > or = 120 g/L group. Further, cross-sectional analysis showed positive correlations between abnormal hematological results and prevalences of vitamin deficiencies. The subjects with iron-deficiency anemia had much higher rates of vitamin C, folate and vitamin B12 deficiencies than those in the nonanemic subjects, and especially in the deficient rates of ascorbic acid and folate in the anemia (Hb < 110 g/L) group, which reached 64.04% and 22.70% respectively. Moreover, we observed that the decreasing trends of hemoglobin concentrations were accompanied by the decreases of serum levels of vitamin A, ascorbic acid, folate and vitamin B12. In conclusion, multiple vitamin deficiencies, especially ascorbic acid, retinol and folic acid, may be associated with anemia or iron deficiency in pregnant women in the last trimester. The study suggested that anemic pregnant women in China should be supplemented with iron and multiple vitamins simultaneously.

Topics: Adult; Anemia; Ascorbic Acid; China; Female; Folic Acid; Hemoglobins; Humans; Iron; Iron Deficiencies; Nutritional Status; Pregnancy; Pregnancy Complications, Hematologic; Pregnancy Trimester, Third; Riboflavin; Vitamin A; Vitamin B 12; Vitamins

In order to investigate the behaviour of biochemical parameters in children from Mozambique, we have determined the serum levels of folic acid and vitamin B12, two well known markers of nutritional anemia. We have correlated their values with other blood parameters and have evidenced potential interesting relationship between folate content and platelets count.

Topics: Adolescent; Anemia; Calcium; Child; Female; Folic Acid; Humans; Magnesium; Male; Megakaryocytes; Mozambique; Nucleotides; Vitamin B 12

The unknown biochemical basis for neurologic dysfunction in cobalamin deficiency and the frequent divergence between neurologic and hematologic manifestations led us to study homocysteine metabolism in 22 patients with pernicious anemia. Serum levels of total homocysteine (tHcy), methionine, S-adenosylmethionine (AdoMet), cysteine, cysteinylglycine (cys-gly), and glutathione (GSH) were measured. Only levels of tHcy and cysteine were increased and only GSH was decreased in cobalamin deficiency as a whole, compared with 17 control subjects. AdoMet correlated only with methionine levels (P =.015) and cysteine only with cys-gly (P =.007) in healthy subjects, but in cobalamin-deficient patients AdoMet correlated instead with cysteine, cys-gly, and folate levels only (P =.008, P =.03, and P =.03, respectively). Significant differences appeared in clinically subgrouped cobalamin-deficient patients. The 11 patients with neurologic defects had higher mean levels of folate (27.9 versus 15.4 nM), AdoMet (117.2 versus 78.6 nM), cysteine (462 versus 325 microM), and cys-gly (85.0 versus 54.7 microM) than the 11 neurologically unaffected patients. Cobalamin therapy restored all metabolic changes to normal. The results indicate that changes in several metabolic pathways differ in patients with and without neurologic dysfunction. Cysteine levels were the most significant predictors of neurologic dysfunction, but it is unclear if they are direct or indirect indicators of neurotoxicity. The higher AdoMet levels in neurologically affected patients may result from inhibition of glycine N-methyltransferase by those patients' higher folate levels. The origin of the folate differences is unclear and possibly varied. Low AdoMet and GSH levels were independent predictors of anemia.

Topics: Anemia; Anemia, Pernicious; Cysteine; Dipeptides; Folic Acid; Glutathione; Homocysteine; Humans; Memory Disorders; Methionine; Movement Disorders; Nervous System Diseases; Retrospective Studies; S-Adenosylmethionine; Sensation Disorders; Vitamin B 12; Vitamin B 12 Deficiency

Studies conducted in Guatemala, Mexico, and Venezuela have found high prevalences of low plasma cobalamin (vitamin B-12) concentrations in infants and children. It is not known whether these low cobalamin concentrations are accompanied by altered metabolic functions.. We sought to assess the prevalence of cobalamin deficiency in Guatemalan children by using sensitive and specific markers of deficiency.. Children (n = 553) were screened for low plasma cobalamin. Those with low plasma cobalamin (< 162 pmol/L) were matched by age, grade, and sex to those with marginal (162-221 pmol/L) and adequate (> 221 pmol/L) concentrations. In this matched subset (n = 180), additional biochemical indicators of cobalamin deficiency were measured.. Of the 553 children screened, 11% had low plasma cobalamin and an additional 22% had marginal concentrations. The prevalences of elevated serum methylmalonic acid (MMA), plasma homocysteine, or both were significantly higher in children with low and marginal plasma cobalamin than in children with adequate plasma cobalamin. Mean serum MMA was high in all groups compared with values reported in other populations. Mean plasma holotranscobalamin II concentrations were significantly lower in children with low rather than marginal or adequate plasma cobalamin. However, holotranscobalamin II was a less sensitive indicator of cobalamin depletion than was MMA.. Biochemical markers of cobalamin deficiency confirmed that the cobalamin status of children with low and marginal plasma cobalamin is inadequate to support normal metabolic function.

Topics: Analysis of Variance; Anemia; Biomarkers; Child; Creatinine; Female; Folic Acid; Guatemala; Hematocrit; Hemoglobins; Homocysteine; Humans; Male; Mass Screening; Methylmalonic Acid; Prevalence; Transcobalamins; Vitamin B 12; Vitamin B 12 Deficiency

To investigate the effects of tobacco smoking on serum vitamin B12, folic acid and haematological parameters in healthy Thai smokers and non-smokers.. Cross-sectional study of smokers and non-smokers in a military unit in Bangkok, Thailand.. A military unit in Thailand.. One hundred and twenty-three male smokers from a military unit in Bangkok, who participated voluntarily in the study, were investigated. Sixty-six male non-smokers from the same unit were selected as controls. Fasting blood samples were collected for investigation of vitamin B12, folic acid and haematological variables.. The serum folic acid concentration of smokers was lower than that of non-smokers, but was not statistically significantly different. Haemoglobin was lower in smokers than in non-smokers; 16.3% of smokers were anaemic compared with only 3.0% of non-smokers. Anaemia was not related to folate deficiency. The white blood cell count was found to be higher in smokers than in non-smokers.. The results of this study suggest that there were low serum folic acid concentrations in smokers compared with non-smokers, which might contribute to the development of vascular and cardiovascular diseases. The higher white blood cell count might be indicative alterations in the immune functions of smokers.

Topics: Adult; Anemia; Cardiovascular Diseases; Case-Control Studies; Cross-Sectional Studies; Erythrocyte Indices; Folic Acid; Folic Acid Deficiency; Hematologic Tests; Humans; Leukocyte Count; Male; Middle Aged; Risk Factors; Smoking; Thailand; Vitamin B 12; Vitamin B 12 Deficiency

The aim of the study was the analysis of the blood biochemical indices values depending on the nutrition model. The research was carried out in 1999 year among at random chosen 188 people 75-80 years old residing the neighbourhood of Olsztyn. The nutrients intake was assessed by means of the 24-hour recall method and, after having included loses, was compared with the recommended intake on the safe level. The blood biochemical indices were defined in the Central Analytical Laboratory of the City Hospital in Olsztyn according to the standard procedure. The analysis was assessed by Statistica v.6.0 program with the application of the factor and cluster analysis. Three nutrition models were separated: "low nutritive", "dairy" and "meat-vegetable-fruit". The comparison and distribution of the mean blood biochemical value was carried out using the variance analysis and the chi 2 test at p < or = 0.05. No differentiation in the levels of most blood biochemical indices depended on women and men nutrition model has been confirmed. Among 1-16% of women and 12-28% of men too low haematocrit and haemoglobin values were stated, among 34% of women and 23% of men--too low albumin values, and among 24% of women and 11% of men too high glucose values in the blood were found. About 32% of women and 35% of men showed too low HDL cholesterol ratio to total cholesterol content. Too low value of the vitamin B12 in the blood was revealed for 6% of women and 5% of men, and folic acid among 26% and 37%, for women and men, respectively. Regardless of realized nutrition model the significant percentage of elderly people has been characterized with the increased risk of cardiovascular diseases, diabetes or anaemia.

Topics: Aged; Aged, 80 and over; Aging; Albumins; Anemia; Biomarkers; Blood Glucose; Cardiovascular Diseases; Cholesterol, HDL; Diabetes Mellitus; Diet; Female; Folic Acid; Hematocrit; Hemoglobins; Humans; Male; Risk Factors; Vitamin B 12

We have examined the independent effect of vitamin B(12) deficiency on hematological indices in older Chinese vegetarian women using a cross-sectional study design: 119 women older than 55 years who had been vegetarian for more than 3 years were studied. Fasting blood samples were taken for complete blood count, serum iron, total serum iron binding capacity, serum iron saturation, serum vitamin B(12), serum folate, serum methylmalonic acid levels (MMA), and renal function test. Subjects with iron deficiency (iron saturation <15%) and those with serum creatinine >150 mmol/L were excluded. The prevalence of definite vitamin B(12) deficiency (vitamin B(12) level < 150 pmol/L and MMA >or= 0.4 micromol/L) was 42%. Another 32.8% had possible vitamin B(12) deficiency (either criterion). The prevalence of iron deficiency was 10%. After exclusions, 96 subjects were further analyzed. Vitamin B(12) deficiency defined by serum vitamin B(12) and MMA was associated with a decrease in hemoglobin concentrations by up to 0.9 g/dL, but it was not associated with an increase in mean corpuscular volume (MCV). Serum MMA but not vitamin B(12) levels correlated inversely with hemoglobin and platelet counts and positively with MCV, after adjustment of confounding factors. However, the percentage of subjects with anemia did not increase significantly until serum MMA became >1.0 micromol/L. In conclusion, vitamin B(12) deficiency was associated with a significant decrease in hemoglobin concentration. However, anemia associated with vitamin B(12) deficiency was seldom macrocytic. We recommend that older vegetarians should be given vitamin B(12) supplements routinely.

Topics: Aged; Anemia; Blood Cell Count; Blood Proteins; China; Cross-Sectional Studies; Diet, Vegetarian; Erythrocyte Indices; Female; Folic Acid; Hemoglobins; Humans; Iron; Iron Deficiencies; Kidney; Methylmalonic Acid; Middle Aged; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Anemia; Erythrocytes; Folic Acid; Humans; Immunoenzyme Techniques; Reagent Kits, Diagnostic; Vitamin B 12

Iron and folate malabsorption are common in untreated celiac disease as the proximal small intestine is predominantly affected. Vitamin B12 deficiency is thought to be uncommon, as the terminal ileum is relatively spared. This study aims to investigate the prevalence of vitamin B12, deficiency in patients with untreated celiac disease.. Prospective study of 39 consecutive biopsy-proven celiac disease patients (32 women, seven men; median age 48 yr, range 22-77 yr) between September 1997 and February 1999. The full blood count, serum vitamin B12, red blood cell folate, and celiac autoantibodies (IgA antigliadin and IgA antiendomysium antibodies) were measured before and after a median of 4 months (range 2-13 months) of treatment with a gluten-free diet. In vitamin B12-deficient patients, intrinsic factor antibodies and a Schilling test, part 1, were performed.. A total of 16 (41%) patients were vitamin B12 deficient (<220 ng/L) and 16 (41%) patients (11 women and live men) were anemic. Concomitant folate deficiency was present in only 5/16 (31%) of the vitamin B12 patients. The Schilling test, performed in 10 of the vitamin B12-deficient patients, showed five low and five normal results. Although only five patients received parenteral vitamin B12, at follow-up the vitamin B12 results had normalized in all patients. Acral paraesthesia at presentation in three vitamin B12-deficient patients resolved after vitamin B12 replacement.. Vitamin B12 deficiency is common in untreated celiac disease, and concentrations should be measured routinely before hematinic replacement. Vitamin B12 concentrations normalize on a gluten-free diet alone, but symptomatic patients may require supplementation.

Topics: Adult; Aged; Anemia; Antibodies; Celiac Disease; Diet; Female; Gliadin; Glutens; Humans; Immunoglobulin A; Male; Middle Aged; Oligopeptides; Prospective Studies; Vitamin B 12; Vitamin B 12 Deficiency

Although the occurrence of iron deficiency anemia and hemoglobinopathies in Vietnamese immigrants has been reported, folate and vitamin B12 deficiencies have not. Proper diagnosis and effective treatment is necessary to achieve a complete correction of anemia.. We retrospectively analyzed the records of Vietnamese immigrants seen in our medical clinic from 1991 to 1993. Fifty-nine anemic patients (48 females and 11 males) had low levels of red blood cell (RBC) folate and/or serum vitamin B12.. The patients' mean age was 37.7+/-17 years. Mean hemoglobin and hematocrit values were 11.4+/-0.7 g/dL and 34.4%+/-2.2%, respectively. Mean corpuscular volume (MCV) was normal in 40 patients (68%) (mean, 89.1+/-5 fL) and low in 19 patients (32%) (mean, 69.7+/-6 fL). Forty-four patients had low RBC folate levels (mean, 157.7+/-41.7 ng/mL). Twenty patients had low serum vitamin B12 levels (mean, 165.6+/-47 pg/mL). Fourteen patients had ferritin levels of <20%.. Concomitant folate, vitamin B12, and iron deficiencies or hemoglobinopathies might have been responsible for either normal or low MCV in some of our anemic patients. In this ethnic group, RBC folate and serum vitamin B12 levels should be determined in all anemic patients.

Topics: Adolescent; Adult; Aged; Anemia; California; Child, Preschool; Erythrocyte Indices; Erythrocytes; Female; Ferritins; Folic Acid; Folic Acid Deficiency; Hematocrit; Hemoglobins; Humans; Male; Middle Aged; Retrospective Studies; Vietnam; Vitamin B 12; Vitamin B 12 Deficiency

To examine erythropoiesis in renal transplant pregnancies.. Retrospective cohort study of 30 renal transplant cases and 30 age, smoking and parity-matched healthy controls with normal index pregnancy. Retrospective chart review and assay of frozen antenatal serum (for serum erythropoietin concentration [serum EPO]), transferrin receptor protein [TfR], ferritin, folate and B12) were performed. The linear regression equation for normal pregnancy controls was used to calculate predicted [serum EPO] and the observed/predicted (O/P) log [serum EPO] was plotted. The relationship between [serum EPO] and haemoglobin (Hb) among transplant cases was considered to be different from that among controls if the slope of the O/P log [serum EPO] versus Hb regression was significantly different from zero.. The transplant (14 cadaveric) to conception interval was (median [range]) 33.5 [4, 189] months. Immunosuppressants were azathioprine (n = 25), cyclosporine (n = 22) and/or prednisone (n = 25). Cases were more often primiparous (20 vs. 7 [controls]; p = 0.01), had pre-existent hypertension (20 vs. 0 [controls]; p < 0.001), developed new/increased hypertension or pre-eclampsia (28 vs. 0 [controls]; p < 0.001) and an antenatal rise in creatinine (14 vs. 2 [controls]; p < 0.001). In early pregnancy, cases had similar EPO (15.2 [2.6, 84.6] vs. 15.7 [6.4, 41.0] [controls] U/L) but lower Hb (101 [65, 129] vs. 116 [106, 150] g/L; p < 0.001). Twenty-two (73%) cases had Hb < 100 g/L (vs. 4 [controls]; p < 0.0001); Hb was comparable at 6 wk postpartum. With advancing gestational age (GA), Hb remained stable and serum EPO increased in both groups. The slope of the O/P log [serum EPO] versus Hb for transplant cases was significantly different from zero within both the 17-28 wk (slope +/- SEM: 0.010 +/- 0.002; p < 0.0001) and the 29-42 wk GA categories (0.006 +/- 0.003; p = 0.02). Cases showed smaller rises in serum TfR (change 481 [- 1471, 2780]) vs. 1119 [- 698, 4195] [controls] ng/mL; p = 0.005).. Anaemia frequently complicates renal transplant pregnancies, in which serum EPO is inappropriately low and the rate of erythropoiesis blunted.

Topics: Adult; Anemia; Case-Control Studies; Cohort Studies; Creatinine; Erythropoiesis; Erythropoietin; Female; Ferritins; Folic Acid; Gestational Age; Hemoglobins; Humans; Hypertension; Immunosuppressive Agents; Kidney Transplantation; Linear Models; Parity; Pre-Eclampsia; Pregnancy; Pregnancy Complications, Cardiovascular; Pregnancy Complications, Hematologic; Receptors, Transferrin; Retrospective Studies; Time Factors; Vitamin B 12

A six-month-old beagle was presented with a three-month history of failure to gain weight, lethargy, intermittent vomiting and seizures. Hypoglycaemia, portosystemic shunt, lead intoxication, gastrointestinal diseases and hereditary metabolic disorders were considered. Laboratory test results of low serum cobalamin (Cbl) concentrations, anaemia, leucopenia and methylmalonic aciduria while the dog was receiving a balanced commercial canine diet were suggestive of a congenital selective Cbl malabsorption. Treatment with repeated injections of parenteral cyanocobalamin (CN-Cbl) at 50 microg/kg every two weeks corrected the Cbl-deficient state and reversed all the clinical abnormalities. Selective Cbl malabsorption has previously been described in giant schnauzers and border collies and represents a unique readily treatable hereditary metabolic disorder.

Topics: Anemia; Animals; Dogs; Leukopenia; Male; Seizures; Vitamin B 12; Vitamin B 12 Deficiency; Vomiting; Weight Gain

Clinical and hematological profile of chronic anemia in children after orthotopic liver transplantation (OLT) is unknown.. We prospectively studied children after orthotopic liver transplantation (OLT) with hemoglobin levels < 2 standard deviation of age appropriate mean for > 6 months. Investigations included hemogram, reticulocyte count, peripheral blood smear, serum vitamin B-12, folic acid levels, iron studies, Coomb's tests, serum erythropoietin (EPO) levels, and stool and urine tests for occult blood.. Fifty-six participants (22 male and 34 female, mean age 82.9 months, range 20-232, mean post-OLT duration 48.8 months, range 6-132) were studied. The causes of anemia were idiopathic (32), iron deficiency (4), viral infections (2, HIV=1, parvovirus=1), and lymphoproliferative disease (2). Fifteen participants showed spontaneous recovery within 1-6 months. Thirty-one children with idiopathic anemia had low or normal EPO levels (mean 7.33 mmicro/L, range <2.5 to 15.9, normal 4-24). When outliers (iron deficiency=4, HIV disease= 1) were excluded, there was no statistical correlation between hematocrits and EPO levels. Serum vitamin B-12 levels (n=52) were elevated (normal 110-930 pg/ml) (mean=1,186 pg/ml) in 32 (61.5%) and were significantly higher in those with abnormal liver function tests.. Anemia is a common problem in children after OLT. More than half the participants had anemia of unknown etiology with an inappropriate EPO response for the degree of anemia. The normal negative correlation between hematocrit and EPO was lost in these children. The observation regarding serum vitamin B-12 levels requires further study.

Topics: Adolescent; Anemia; Child; Child, Preschool; Cross-Sectional Studies; Erythropoietin; Female; Ferritins; Folic Acid; Hemoglobins; Humans; Iron; Liver Transplantation; Male; Retrospective Studies; Vitamin B 12

Serum erythropoietin (sEpo) concentration is primarily related to the rate of renal production and, under the stimulus of hypoxia, increases exponentially as hemoglobin (Hb) decreases. Additional factors, however, appear to influence sEpo, and in this work, we performed studies to evaluate the role of the red blood cell precursor mass. We first compared the relationship of sEpo with Hb in patients with low versus high erythroid activity. The first group included 27 patients with erythroid aplasia or hypoplasia having serum transferrin receptor (sTfR) levels < 3 mg/L (erythroid activity < 0.6 times normal), while the second one included 28 patients with beta-thalassemia intermedia having sTfR levels > 10 mg/L (erythroid activity > 2 times normal). There was no difference between the two groups with respect to Hb (8.3 +/- 1.6 v 8.0 +/- 1.3 g/dL, P > .05), but sEpo levels were notably higher in patients with low erythroid activity (1,601 +/- 1,542 v 235 +/- 143 mU/mL, P < . 001). In fact, multivariate analysis of variance (ANOVA) showed that, at any given Hb level, sEpo was higher in patients with low erythroid activity (P < .0001). Twenty patients undergoing allogeneic or autologous bone marrow transplantation (BMT) were then investigated. A marked increase in sEpo was seen in all cases at the time of marrow aplasia, disproportionately high when compared with the small decrease in Hb level. Sequential studies were also performed in five patients with iron deficiency anemia undergoing intravenous (IV) iron therapy. Within 24 to 72 hours after starting iron treatment, marked decreases in sEpo (up to one log magnitude) were found before any change in Hb level. Similar observations were made in patients with megaloblastic anemia and in a case of pure red blood cell aplasia. These findings point to an inverse relationship between red blood cell precursor mass and sEpo: at any given Hb level, the higher the number of red blood cell precursors, the lower the sEpo concentration. The most likely explanation for this is that sEpo levels are regulated not only by the rate of renal production, but also by the rate of utilization by erythroid cells.

Topics: Anemia; Anemia, Aplastic; Anemia, Hypochromic; Anemia, Megaloblastic; Antineoplastic Combined Chemotherapy Protocols; beta-Thalassemia; Bone Marrow Transplantation; Erythrocyte Indices; Erythroid Precursor Cells; Erythropoiesis; Erythropoietin; Feedback; Folic Acid; Hodgkin Disease; Humans; Iron; Kidney; Receptors, Transferrin; Transplantation Conditioning; Vitamin B 12

to discover whether vitamin B12 levels influence erythropoietin (EPO) response during pregnancy.. 117 pregnant women after the 27th week were divided into three groups according to log vitamin B12 concentrations. EPO (by enzyme-linked immunosorbent assay), Hemoglobin (Hb) and medium corpuscular Hb concentration (MCHC) were measured in these patients. The tests used were: calculation of simple statistic, regression coefficient and t-independent test with level of significance. An exclusive partitioned cluster method (K-means procedure) was used.. For the lowest vitamin B12 levels there is an unexpected lack of difference in plasma EPO levels between anemic and nonanemic patients. In fact EPO levels were high even in nonanemic women. The only parameter of the blood count that seems to change in relation to vitamin B12 concentration is the MCHC.. These results suggest that low vitamin B12 levels inhibit the suppression of EPO response in nonanemic pregnant women probably through MCHC modifications.

Topics: Adolescent; Adult; Anemia; Erythrocyte Indices; Erythropoietin; Female; Gestational Age; Hemoglobins; Humans; Pregnancy; Pregnancy Complications, Hematologic; Vitamin B 12

Over a 2-year period, we examined 48 patients with P-cobalamin levels in the difficult "grey zone" at the lower reference limit detected by a competitive protein binding assay using intrinsic factor as binder. In 21 of 30 patients (70%) with low P-cobalamins we could not establish the diagnosis of metabolic cobalamin deficiency, but 1 of 18 patients (6%) with low-normal P-cobalamin values was confirmed metabolically cobalamin-deficient. Half of these 30 patients with low P-cobalamins had neuropsychiatric disorders, but only one-third of the latter patients had metabolic cobalamin deficiency. Ten of the remaining 15 patients (67%) were characterized as non-deficient. In patients with low-normal P-cobalamin level, we found neuropsychiatric disorders in 5 of the 18 (28%), but none of these had metabolic cobalamin deficiency. We conclude that P-cobalamins below the reference interval combined with typical neuropsychiatric symptoms or findings are not diagnostic of cobalamin deficiency and that further analyses are necessary.

Topics: Adult; Aged; Aged, 80 and over; Anemia; Anemia, Macrocytic; Female; Humans; Malabsorption Syndromes; Male; Mental Disorders; Middle Aged; Nervous System Diseases; Prospective Studies; Vitamin B 12; Vitamin B 12 Deficiency

To establish the ranges of full blood count (FBC), vitamin B12 and folate levels and to determine the prevalence of occult haematological abnormalities in older Zimbabweans.. Community based cross sectional survey.. 278 randomly selected healthy Zimbabweans aged > 65 years. INTERVENTIONS/STUDY FACTORS: Haemoglobin level, MCV, folate, B12 alcohol consumption.. The median Hb was males 14.0 (range 8 to 18.3), females 13.1 g/dl (7.9 to 18.1). 23% were anaemic (Hb < 13 g/dl in males, < 12 g/dl in females), 3% with microcytic and 20% with macrocytic indices. Overall 13% had low vitamin B12 and 30% had low folate levels. Folate levels were significantly lower in urban subjects and B12 levels were significantly lower in rural subjects. Fifty four subjects (21%) had an MCV > 100 fl. In this group, low folate levels were found in 22, low B12 levels in nine, excessive alcohol in eight and two subjects had elevated TSH. The MCV was higher in urban subjects.. This study has revealed a large amount of occult haematological abnormality and interesting differences between rural and urban subjects. It focuses attention on low levels of folate, which should be preventable by simple nutritional education, as an extensive problem in the community.

Topics: Aged; Aged, 80 and over; Alcohol Drinking; Anemia; Anemia, Macrocytic; Blood Cell Count; Cross-Sectional Studies; Female; Folic Acid; Health Surveys; Humans; Male; Middle Aged; Prevalence; Residence Characteristics; Vitamin B 12; Zimbabwe

Topics: Adult; Anemia; Fever; Heart Valve Prosthesis; Humans; Male; Splenomegaly; Vitamin B 12; Vitamin B 12 Deficiency

We reviewed the records of seven patients with low serum cobalamin levels that were difficult to interpret in relation to haemoglobin concentrations and clinical symptoms. Myelodysplastic syndrome was diagnosed in four out of five anaemic patients. Three of them had a true vitamin B12 deficiency at the same time. The fifth patient had a non-Hodgkin lymphoma with Coombs-negative autoimmune haemolytic anaemia. Two patients had low cobalamin levels without anaemia. Measurements of plasma homocysteine and serum methylmalonic acid may be useful for diagnosing true vitamin B12 deficiency.

Topics: Aged; Anemia; Diagnosis, Differential; Female; Humans; Male; Vitamin B 12; Vitamin B 12 Deficiency

Serum vitamin B12, folic acid, ferritin and haematological variables were investigated in eighty-seven male and nineteen female construction site workers in Bangkok. Haemoglobin concentration, haematocrit and MCHC were found to be higher in male than in female workers. Serum ferritin was slightly higher in males than in females. Serum B12 was found to be higher in male than in female workers and serum folic acid level were significantly higher in female than in male workers. Vitamin B12 deficiency was found in 2.3 per cent and folic acid deficiency in 6.9 per cent of the male workers. Serum vitamin B12 and folic acid levels were normal for female workers. The adequate serum levels of vitamin B12 and folic acid might be the result of the habit of the workers to consume tonic drinks which contain glucose, caffeine, and vitamins especially vitamins B6, and B12.

Topics: Adolescent; Adult; Aged; Anemia; Confidence Intervals; Female; Ferritins; Folic Acid; Hematologic Tests; Humans; Male; Middle Aged; Nutritional Status; Occupations; Thailand; Vitamin B 12

In this cross-sectional study of 178 pregnant women between the 7th and 42nd week of pregnancy, we analyzed correlations between erythropoietin (EPO) and vitamin B12 (B12) in different stages of pregnancy and in relation to hemoglobin (Hb) levels. Patients with hypertension, fetal growth retardation and severe systemic diseases were excluded. EPO (by ELISA), B12 (by RIA) and Hb were assayed in the same blood sample taken on admission. On the basis of weeks of pregnancy, EPO levels and B12 levels, the 178 subjects were found to fall into two clusters, before and after the 27th week of gestation. The correlation coefficient between EPO and B12 was highly significant in the first group but not in the second (R = -0.33; p < 0.01). When the patients were divided on the basis of Hb levels (< or = or > 11 g/dl), a significant correlation was found only in the 88 patients with Hb > 11 g/dl (R = -0.44; p < 0.001) and not in the 72 anemic subjects. Moreover, in the former group the correlation between EPO and B12 was high before and after the 27th week, unlike in the latter group for which no significant correlation was found. These results suggest that EPO and B12 act together to establish normal erythropoiesis in pregnancy.

Topics: Adult; Anemia; Cross-Sectional Studies; Erythropoietin; Female; Hemoglobins; Humans; Pregnancy; Pregnancy Complications, Hematologic; Pregnancy Trimester, Third; Vitamin B 12

The oral manifestations of glossitis, stomatitis and mucosal ulceration in vitamin B12 deficiency have long been recognised. These oral changes may occur in the absence of symptomatic anaemia or of macrocytosis. The aim of this paper is to describe a retrospective study of the wide range of oral signs and symptoms reported by 14 patients found to have a previously undiagnosed vitamin B12 deficiency. None of the patients described in this study had generalised symptoms sufficiently advanced to arouse suspicions of vitamin B12 deficiency. The essential criteria for the diagnosis of pernicious anaemia are also discussed.

Topics: Anemia; Anemia, Macrocytic; Anemia, Pernicious; Burning Mouth Syndrome; Cheilitis; Female; Glossalgia; Glossitis; Humans; Male; Mouth Diseases; Mouth Mucosa; Retrospective Studies; Stomatitis; Stomatitis, Denture; Ulcer; Vitamin B 12; Vitamin B 12 Deficiency

A cross-sectional study was undertaken to assess the haematological condition of the San (Bushmen) relocated from Namibia to South Africa. We studied 238 subjects--145 men and 93 women; none of the women was pregnant. We performed full blood counts and estimations of serum vitamin B12, folate, ferritin and erythrocyte folate concentrations. The mean haemoglobin concentration among the men was 14.7 g/dl and 19 (13%) were anaemic; among the women it was 13.8 g/dl and 18 (19%) were anaemic. Thirteen (9%) of the men and 22 (24%) of the women had low concentrations of serum ferritin, and 38 (26%) of the men and 22 (24%) of the women had erythrocyte folate concentrations of less than 270 nmol/l. Three (2%) men and 4 (4%) women had serum vitamin B12 concentrations of less than 120 pmol/l. Eighty-one (56%) of the men and 76 (82%) of the women had eosinophilia, probably because of parasitic infections. It would appear from this and previous studies that prolonged exposure of these hunter-gatherers to a Western lifestyle has resulted in a high prevalence of anaemia, caused by low iron and folate intakes, complicated by alcohol consumption.

Topics: Adolescent; Adult; Aged; Anemia; Black People; Cross-Sectional Studies; Eosinophilia; Erythrocytes; Feeding Behavior; Female; Ferritins; Folic Acid; Hematologic Tests; Humans; Leukocyte Count; Male; Middle Aged; Namibia; Nutritional Status; South Africa; Vitamin B 12

To determine the prevalence and causes of anemia in rural Mexico, blood samples and longitudinal dietary data were collected from 187 women, some pregnant and then lactating, and from 72 men. Blood was used to measure anemia, mean cell volume, and plasma ferritin, folate and vitamin B-12. Anemia was found in 33% of the men, 54% of nonpregnant, nonlactating women, 35% of pregnant women and 41% of lactating women, and varied by season. Low iron stores (ferritin) accompanied anemia in only 8% of men compared with 38-67% of women. Low meat intake and poor dietary iron bioavailability were associated with anemia in women. There were no cases of low plasma folate. Low plasma vitamin B-12 was common in all groups, and the incidence increased from 15% at 7 mo of pregnancy to 30% at 7 mo of lactation. Vitamin B-12 was lower in the plasma and milk of anemic lactating women than in plasma and milk of non-anemic lactating women and was classified as deficient in 62% of breast milk samples.

Topics: Adult; Anemia; Diet; Female; Folic Acid Deficiency; Humans; Iron Deficiencies; Lactation; Longitudinal Studies; Male; Mexico; Middle Aged; Milk, Human; Pregnancy; Pregnancy Complications; Rural Population; Vitamin B 12; Vitamin B 12 Deficiency

This study was designed to investigate the development of anemia during functional ileoanal pouch.. Eighty-three patients received an ileoanal pouch between 1980 and 1987. The hematology data deviations among the preoperative period, defunctionalized stage, and after ileal pouch in function were monitored. Aspects studied included serum hemoglobin, iron, folates, vitamin B12, white blood cell, erythrocyte sedimentation rate, pt-B12, and fat absorption. Specimens were collected before colectomy, during ileostomy prior to pouch operation, before loop ileostomy closure, and at 6, 12, 18, 24, and 36 months after loop ileostomy closure.. Two patients developed iron deficiency anemia after 2.5 and 5 years of pouch function: one patient, a vegetarian, had low hemoglobin, iron, and vitamin B12 postoperatively, the other patient developed low iron and hemoglobin 5 years after the operation. Significant elevations of serum hemoglobin, iron, and folates were seen preoperatively vs. postoperatively from 123.46 +/- 2.845 g/l, 10.282 +/- 0.992 mumol/l, and 9.983 +/- 1.308 mmol/l to 138.842 +/- 1.563 g/l (P < 0.0001), 17.544 +/- 1.529 mumol/l (P < 0.0003), and 16.784 +/- 1.757 mmol/l (P < 0.01) (mean +/- SE) of the defunctionalized loop ileostomy. Serum B12 decreased insignificantly. After loop ileostomy closure, at 6 and 36 months of functional ileal pouch-anal anastomosis, the elevations were still significant; serum hemoglobin was P < 0.0001 and P < 0.01, and serum iron was P < 0.001 and P < 0.01, respectively. Vitamin B12 levels decreased insignificantly at six months in controls and significantly (P < 0.01) at 36 months. There was a significant increase of serum folates (P < 0.01 and P < 0.001). Patients with low iron were 50 percent at precolectomy, 23 percent with ileostomy, 16 percent with loop ileostomy, 15 percent at six-month follow-up, and 11 percent at 12-month follow-up. Although only 3 percent and 11 percent of the patients with ileal pouch-anal anastomosis had low serum vitamin B12 values at the 12-month and 36-month follow-up, 31 percent and 36 percent had decreased Schilling tests. Thirty-three percent and 41 percent had decreased 14C-triolein breath tests. In five patients vitamin B12 deficiency began during the first six months of pouch function: in two patients after one year and in one patient after two years. Eight of 83 patients have had substitution therapy with vitamin B12. The therapy was discontinued in three patients after two to four years; these patients developed no further symptoms and had normal Schilling tests in the succeeding 30 months to 46 months. Five patients continue with substitution after 40 months to 68 months. During the functional period, serum erythrocyte sedimentation rate and white blood cells were elevated in some controls on different occasions. Folates were normal throughout the functional period.. For predicting hematologic data outcome in patients with functional ileal reservoir, the results justify the necessity for control during both manipulative and functional periods until evaluations are reliable and satisfying.

Topics: Adenomatous Polyposis Coli; Adolescent; Adult; Anemia; Blood Sedimentation; Colitis, Ulcerative; Female; Folic Acid; Follow-Up Studies; Hemoglobins; Humans; Iron; Male; Middle Aged; Postoperative Period; Proctocolectomy, Restorative; Schilling Test; Vitamin B 12

Forty two patients who were seen and satisfied the French-American-British (FAB) diagnostic criteria for myelodysplastic syndromes (MDS) over a 6-year period at the University of Zimbabwe's Department of Haematology, Harare, are presented. Their overall ages ranged from 29 to 75 years with a mean +/- SD of 57.8 +/- 11.2 years. Males outnumbered females with a male to female ratio of 1.2:1. Refractory anaemia (RA) occurred in 33.3%; refractory anaemia with ringed sideroblasts (RARS) in 16.7%; refractory anaemia with excess blasts (RAEB) in 21.4%; refractory anaemia with excess blasts in transformation (RAEB-T) in 16.7% and chronic myelomonocytic leukaemia (CMML) in 11.9% of the patients. In 90.5% the disease was primary and in 9.5% prior exposure to myelotoxic agents resulted in secondary MDS. The study reveals that MDS as a cause of anaemia in the African population is usually hidden in the big number of well known anaemias due to rampant malaria, malnutrition and a host of nutritional deficiencies. There is therefore the need to increase diagnostic awareness among our clinicians about the existence of these disorders.

Topics: Adult; Age Factors; Aged; Anemia; Bone Marrow; Female; Folic Acid; Humans; Male; Middle Aged; Myelodysplastic Syndromes; Prospective Studies; Sex Factors; Vitamin B 12; Zimbabwe

To evaluate the influence of blood transfusion on the serum levels of different nutrients, the levels of total iron binding capacity, ferritin, cobalamin and folate were determined before and 24 hours after 2 or 3 packed red cell transfusions, by forty patients with anemia of various causes. No significant change was found in these levels before and after blood transfusion, except for iron and folate.

Topics: Adult; Aged; Aged, 80 and over; Anemia; Blood Transfusion; Female; Ferritins; Folic Acid; Humans; Male; Middle Aged; Transferrin; Vitamin B 12

Owing to the lack of a reference technique and of an international cobalamin (vitamin B12) standard, and the large discrepancy between laboratory norms, the authors performed a multicentric study to compare five RIA kits usually used. First, classical tests were used to evaluate the analytical performances of each kit. Results did not demonstrate any superiority of one kit over another. Secondly, B12 values were classified among three categories (low, normal and high) characterized by laboratory and then manufacturer norms. The concordance between these two "judgments" was evaluated with the Kappa coefficient. In addition, the Kappa index proved that the norms supplied by the manufacturer were better than those of laboratories. But mean Kappa coefficient established for each norm gave us an unsatisfactory result. Third, clinical informations allowed to improve the classification of the patients. New limits were defined for each technique and should be tested further, routinely in each laboratory.

Topics: Anemia; Humans; In Vitro Techniques; Liver Diseases; Radioimmunoassay; Reproducibility of Results; Splenomegaly; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; False Positive Reactions; Humans; Intestinal Absorption; Population Surveillance; Quality Assurance, Health Care; Sweden; Vitamin B 12; Vitamin B 12 Deficiency

Major blood loss following trauma is common, but severe anemia is generally not life-threatening when managed with the administration of blood and blood products. Severe anemia becomes particularly challenging and potentially lethal when the patient is a Jehovah's Witness, for whom receiving a transfusion is contrary to religious principles. This case report describes the management and hospital course of a Jehovah's Witness who was seriously injured in an airplane crash.

Topics: Anemia; Blood Transfusion; Christianity; Clinical Protocols; Critical Care; Delayed-Action Preparations; Enteral Nutrition; Erythropoietin; Ferrous Compounds; Hemoglobins; Humans; Male; Middle Aged; Multiple Trauma; Oxygen Consumption; Treatment Refusal; Vitamin B 12

Thirty patients with anemia of various causes received packed red cell transfusions. To evaluate the influence of blood transfusion on the serum levels of different nutrients, serum ferritin, folate, and cobalamin levels were determined before and 2, 2 to 4, 5 to 7, 8 to 10, and 11 to 14 days after blood transfusion. No significant change was found in these levels before or at any time after blood transfusion. Blood transfusion exerted little effect on the serum levels of ferritin, cobalamin, or folate. Moreover, if the blood for testing was drawn 1 to 14 days after transfusion, nearly all cases of nutritional deficiency anemia could have been diagnosed without the influence of blood transfusion.

Topics: Adult; Aged; Aged, 80 and over; Analysis of Variance; Anemia; Blood Transfusion; Female; Ferritins; Folic Acid; Hemoglobins; Humans; Male; Middle Aged; Time Factors; Vitamin B 12

We describe the first reported case of resistance to human recombinant erythropoietin (rhEPO) treatment caused by vitamin B12 deficiency in a chronic hemodialysis patient. Despite a normal B12 level before rhEPO treatment, resistant anemia together with a low B12 level and a megaloblastic bone marrow developed after only 8 months of rhEPO. There was a rapid reticulocyte response to B12 supplements, and transfusion requirements dropped from 2 units monthly to nothing. Atrophic gastritis was diagnosed through endoscopy and biopsy. Because of the fall in B12 level after 8 months of rhEPO treatment, we analyzed the results of routinely measured B12 levels in 30 hemodialysis patients treated with rhEPO, and found the mean B12 levels to be unchanged before and after rhEPO treatment. Although we found screening for B12 deficiency of little benefit, any patient with rhEPO resistance should have B12 levels tested, given the potentially serious extra-hematological effects of B12 deficiency.

Topics: Aged; Anemia; Erythropoietin; Female; Humans; Kidney Failure, Chronic; Male; Middle Aged; Recombinant Proteins; Renal Dialysis; Retrospective Studies; Vitamin B 12; Vitamin B 12 Deficiency

Erythropoietin was applied subcutaneously to 49 patients, 41 have been treated by hemodialysis, 3 by continuous ambulatory peritoneal-dialysis, 5 had chronic progressive renal failure. Mean initial dose of erythropoietin was 139.4 U/kg/week and maintenance dose 115.9 U/kg/week. In 43% of patients serum ferritin was decreasing during treatment, and in 20% it was low before the commencing of the treatment. During erythropoietin therapy vitamin B12 was decreasing in 22% of the patients, and the substitution was necessary in 18%. Only in 1 patient it was necessary to substitute also folic acid. There were no nonresponders among erythropoietin treated patients. Elevation of blood pressure was observed in half of the patients, hypertensive encephalopathy in 1, and thrombosis of arterio-venous fistula in 3.

Topics: Adult; Anemia; Child; Erythropoietin; Female; Ferritins; Hemoglobins; Humans; Injections, Intravenous; Injections, Subcutaneous; Kidney Failure, Chronic; Male; Peritoneal Dialysis, Continuous Ambulatory; Renal Dialysis; Vitamin B 12

The paper reports the action of the polypeptide preparation made of red cells on erythron system in rat toxic anemia. These polypeptides proved more effective as to erythropoiesis stimulation in phenylhydrasine anemia than vitamin B12 or lek. Red cell polypeptides are considered possible regulators of erythropoiesis.

Topics: Anemia; Animals; Blood Cell Count; Drug Evaluation, Preclinical; Erythrocytes; Female; Iron; Organometallic Compounds; Peptides; Phenylhydrazines; Polysaccharides; Rats; Solutions; Time Factors; Vitamin B 12

Subtle cobalamin deficiency states, where low serum cobalamin levels are not accompanied by megaloblastic anemia or malabsorption of free cobalamin, often display metabolic evidence of cellular depletion as shown by the deoxyuridine suppression test. However, the suppression test abnormalities are usually mild and are sometimes atypical; moreover, their response to cobalamin therapy has never been documented. Four patients with this subtle defect, at least three of whom had food-cobalamin malabsorption, were therefore tested before and after cobalamin treatment. Each patient had low serum cobalamin levels but did not have megaloblastic anemia, and all but one had normal serum levels of methylmalonic acid and total homocysteine. Two patients had mildly but typically cobalamin-deficient deoxyuridine suppression test results (baseline values 15.7% and 12.8%; normal less than 8.5%). The other two patients had normal or borderline baseline values (5.4% and 8.9%) that became abnormal on incubation with methyl tetrahydrofolate (16.1% and 12.3%), a pattern previously noted in subtle acquired and hereditary cobalamin deficiencies. After 6 months of cobalamin therapy, the deoxyuridine suppression test abnormalities reversed in all four patients. These findings show that the mild deoxyuridine suppression test stigmata of subtle cobalamin deficiency respond to therapy and thus represent true metabolic deficiency; the unusual abnormality induced in vitro by added methyl tetrahydrofolate responds as well, indicating that it, too, represents metabolic cobalamin deficiency. The findings provide further proof that subtle cobalamin deficiency often exists even when megaloblastic anemia and malabsorption of free cobalamin are lacking, and that the deoxyuridine suppression test can be a reliable tool for its identification.

Topics: Aged; Aged, 80 and over; Anemia; Bone Marrow; Deoxyuridine; DNA; Female; Humans; Male; Methylmalonic Acid; Vitamin B 12; Vitamin B 12 Deficiency

Imerslund-Najman-Gräsbeck anemia is an infrequent disease with an autosomal recessive pattern of inheritance. The characteristic anomaly is selective malabsorption of vitamin B12 by the ileal mucosa. Diagnosis rests on a positive family history and on the demonstration of megaloblastic anemia with proteinuria. The proteinuria is due to glomerular dysfunction with mesangial proliferation. Management rests on lifelong parenteral administration of vitamin B12. A case of Imerslund anemia with a favorable outcome under vitamin B12 treatment is reported.

Topics: Anemia; Genes, Recessive; Humans; Infant; Male; Pedigree; Syndrome; Vitamin B 12; Vitamin B 12 Deficiency

In various anaemias the values of 8 acute phase factors were determined simultaneously before and at the end of treatment: seromucoid, sialic acid, acid alpha 1-glycoprotein, alpha 1-antitrypsin, haptoglobin, ceruloplasmin, transferrin and fibrinogen. In iron-deficiency anaemia without coexistent inflammatory changes in organs the levels of 4 proteins--seromucoid, alpha 1-antitrypsin, ceruloplasmin and transferrin, were consistently raised. In iron-deficiency anemia with concomitant infection 4 proteins also were increased, but in place of alpha 1-antitrypsin the haptoglobin level was raised. In megaloblastic anaemia the ceruloplasmin level was increased, and in haemolytic anaemia one factor--sialic acid--was decreased. At the end of treatment the concentrations of certain proteins were changed depending on their specific role in various forms of anaemia and on various additional factors. In iron-deficiency anaemia without coexistent infection the concentration of seromucoid was decreased, and in this anaemia with coexistent infection alpha 1-antitrypsin, haptoglobin, and fibrinogen levels were raised, in haemolytic anaemia only fibrinogen was increased, and megaloblastic anaemia was associated with raised seromucoid level. The therapeutic result was good in all these anaemias with the exception of iron-deficiency anaemia associated with infection in which it was less propitious.

Topics: Acute-Phase Proteins; Adolescent; Adult; Aged; Anemia; Anemia, Hemolytic, Autoimmune; Anemia, Hypochromic; Anemia, Megaloblastic; Anemia, Sideroblastic; Female; Glucocorticoids; Humans; Iron; Male; Middle Aged; Vitamin B 12

A prospective study of 60 consecutively admitted patients with HIV infection was performed to document the prevalence, etiology and manifestations of low serum vitamin B-12 in such patients. Low serum B-12 levels were found in 10 patients (16.7%). In 6, vitamin B-12 absorption was impaired and hog intrinsic factor addition did not improve it. Patients with low vitamin B-12 levels showed lower hemoglobin, leukocytes, lymphocytes, CD4 lymphocytes and CD4/CD8 lymphocyte ratio than HIV patients with physiological serum vitamin B-12 levels. However, bone marrow megaloblastosis was found in only 3 low vitamin B-12 patients and the deoxyuridine suppression test was pathological in only 1 case. In 7 patients, parenteral treatment was begun with variable response despite serum vitamin B-12 correction. In conclusion, low serum vitamin B-12 is often found in HIV-infected patients and it could be related to malabsorption, but clear megaloblastic abnormalities and treatment response could not be demonstrated. A decreased concentration of the serum binders due to disturbances in the leukocytes and related immunocompetent cell may play an additional role.

Topics: Adult; Anemia; Female; Gastric Acid; HIV Infections; Humans; Hydroxocobalamin; Intrinsic Factor; Leukocyte Count; Male; Prospective Studies; Vitamin B 12

Topics: Anemia; Female; Ferritins; Folic Acid; Haptoglobins; Humans; Iron; L-Lactate Dehydrogenase; Male; Polycythemia; Protein Binding; Transferrin; Vitamin B 12

The concentration of serum cobalamin (SB12) was estimated in tuberculous Nigerian patients so as to define the role of this vitamin in the pathogenesis of the anaemia of tuberculosis. Complete data in 147 infected subjects before and during treatment and in 50 asymptomatic blood donors revealed no significant difference between mean serum cobalamin (mean SB12) concentrations of patients of both sexes and the asymptomatic controls. No differences were demonstrated between mean SB12 of groups of patients subdivided on the basis of degree of anaemia. Moreover, there was no significant correlation between Hb and SB12. Mean SB12 was essentially similar in patients with localised (300.7 pmol/l) and disseminated (311.1 pmol/l) disease. In the 121 patients with pulmonary tuberculosis, mean SB12 of those with one affected lung (291.9 pmol/l) was not significantly different from those with infection of both lungs (303.5 pmol/l). Antituberculosis therapy did not cause a fall in mean SB12. This study does not provide evidence of any significant abnormality in serum cobalamin concentration in Nigerians suffering from localised or disseminated tuberculosis. There is, therefore, no rational basis for the widespread but costineffective practice of supportive oral or parenteral vitamin B12 therapy in the management of this disease.

Topics: Adolescent; Adult; Anemia; Child; Female; Humans; Male; Middle Aged; Nigeria; Tuberculosis; Vitamin B 12

In order to determine the relevance of low vitamin B12 concentration in elderly persons (greater than 65 years), serum vitamin B12 levels were measured in 292 consecutive patients upon their admission to a geriatric ward. Eighty (27%) of them were anaemic (haemoglobin less than or equal to 7.14 mmol/l). The vitamin B12 concentration was not statistically different between males and females, nor between the anaemic and non-anaemic groups. Twenty-two patients (7.5%) had a low vitamin B12 level; of these, 10 had a haemoglobin concentration higher than 7.14 mmol/l and a mean corpuscular volume lower than 98 fl. In addition, serum vitamin B12 levels were also measured in 178 consecutive anaemic patients hospitalized in the same ward. Seventeen (9.5%) of them had a vitamin B12 deficiency although in 11 the MCV was lower than 98 fl. Hypersegmented polymorphonuclear leukocytes were rarely observed in the peripheral blood smear. Pernicious anaemia could only be diagnosed in 1 patient. Serum vitamin B12 estimation may be necessary to detect vitamin B12 deficiency but a low level requires additional diagnostic investigation.

Topics: Aged; Aged, 80 and over; Anemia; Erythrocyte Indices; Female; Hemoglobins; Humans; Inpatients; Male; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Anemia; Blood Transfusion; Cell Survival; Erythropoiesis; Female; Folic Acid; Hematologic Tests; Humans; Male; Nutritional Physiological Phenomena; Pyridoxine; Vitamin B 12

The sensitivities and specificities of the mean cell volume (MCV), the red cell distribution width (RDW), and blood smear hypersegmentation for B12 deficiency were reviewed in 515 patients whose B12 levels were determined. 61 patients had B12 levels less than 200 pg/ml. 43 patients were defined as B12 deficient (n = 13) or non-B12 deficient (n = 30). Hypersegmentation was more sensitive (91%) than MCV greater than 95 fl (62%) or RDW greater than 15% (54%) in detecting B12 deficiency. The MCV and the RDW should not be relied on when screening for B12 deficiency; examination of the blood smear for hypersegmentation is essential.

Topics: Anemia; Erythrocyte Indices; Female; Humans; Male; Middle Aged; Neutrophils; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Anemia; Biological Assay; Humans; Liver Neoplasms; Myeloproliferative Disorders; Pancreatitis; Radioisotope Dilution Technique; Reference Values; Vitamin B 12; Vitamin B 12 Deficiency

Two anemic patients with rheumatoid arthritis were treated with recombinant human erythropoietin (EPO) for 5 months. Both patients showed significant increases in hematocrit, red cell volumes, and marrow erythroid and megakaryocyte progenitor cells. No significant toxic effects from EPO were observed. These data indicate that EPO may be effective in overcoming the pathogenetic factors that limit erythropoiesis in rheumatoid arthritis.

Topics: Adult; Anemia; Arthritis, Rheumatoid; Blood Cell Count; Bone Marrow; Colony-Forming Units Assay; Erythropoietin; Female; Hematocrit; Humans; Middle Aged; Recombinant Proteins; Vitamin B 12

Exertional dyspnea and fatigue dominated the clinical picture of pernicious anemia in a 78 year old man. A disturbed gait indicated concomitant neurologic disorders. A reduced Vitamin B12 level, an abnormal Schillingtest, atrophy of gastric mucosa as well as maturation disturbance of erythrocytes and neutrophils were present as typical signs of the disease. Administration of Cyanocobalamine led to correction of blood values within three weeks.

Topics: Aged; Anemia; Anemia, Pernicious; Fatigue; Gait; Humans; Male; Vitamin B 12; Vitamin B 12 Deficiency

Among 141 consecutive patients with neuro-psychiatric abnormalities due to cobalamin deficiency, we found that 40 (28 percent) had no anemia or macrocytosis. The hematocrit was normal in 34, the mean cell volume was normal in 25, and both tests were normal in 19. Characteristic features in such patients included paresthesia, sensory loss, ataxia, dementia, and psychiatric disorders; longstanding neurologic symptoms without anemia; normal white-cell and platelet counts and serum bilirubin and lactate dehydrogenase levels; and markedly elevated serum concentrations of methylmalonic acid and total homocysteine. Serum cobalamin levels were above 150 pmol per liter (200 pg per milliliter) in 2 patients, between 75 and 150 pmol per liter (100 and 200 pg per milliliter) in 16, and below 75 pmol per liter (100 pg per milliliter) in only 22. Except for one patient who died during the first week of treatment, every patient in this group benefited from cobalamin therapy. Responses included improvement in neuropsychiatric abnormalities (39 of 39), improvement (often within the normal range) in one or more hematologic findings (36 of 39), and a decrease of more than 50 percent in levels of serum methylmalonic acid, total homocysteine, or both (31 of 31). We conclude that neuropsychiatric disorders due to cobalamin deficiency occur commonly in the absence of anemia or an elevated mean cell volume and that measurements of serum methylmalonic acid and total homocysteine both before and after treatment are useful in the diagnosis of these patients.

Topics: Adolescent; Adult; Aged; Anemia; Anemia, Megaloblastic; Ataxia; Erythrocyte Indices; Erythrocytes; Female; Hematocrit; Homocysteine; Humans; Hypesthesia; Iron; Male; Methylmalonic Acid; Middle Aged; Nervous System Diseases; Neurocognitive Disorders; Paresthesia; Vitamin B 12; Vitamin B 12 Deficiency

A representative sample (n = 486) of a 75-year-old population was studied, and probands with defined laboratory aberrations were re-investigated. Anaemia was present in 6% of the men and 3% of the women; in 17/22 anaemic subjects a cause was found. The prevalence of plasma cobalamin concentrations less than 130 pmol/l was 6%, of iron deficiency approximately 6%. Divergences in white blood cell and platelet counts were rare. The observed haematological aberrations were almost always caused by disease. Reference intervals for haematological components were calculated in the total study group and two reference sample groups after exclusions based on anamnestic and/or laboratory screening criteria or anamnestic criteria and/or verified disease. The lower reference limits for B-Hb and P-B12 in a group obtained after exclusions based on anamnestic and screening data were considered to be minimum values for healthy subjects. The WHO criteria for anaemia were applicable.

Topics: Aged; Aging; Anemia; Anemia, Hypochromic; Female; Hematologic Diseases; Hemoglobins; Humans; Longitudinal Studies; Male; Sweden; Vitamin B 12

Topics: Adolescent; Adult; Anemia; Blood Donors; Female; Humans; Male; Middle Aged; Pregnancy; Pregnancy Complications, Hematologic; Vitamin B 12; Vitamin B 12 Deficiency

Serum ferritin, folate, cobalamin and hemoglobin concentrations were determined by radioimmunoassay, radioisotopic assay, radioassay and an automated hematology analyser respectively, and then analysed in 221 normal full-term pregnant women in order to evaluate the incidence and the prevalence of nutritional anemia in pregnancy. None of them had received any hematonic during their pregnancy. Their mean age was 27.68 years and the mean duration of pregnancy was 39.51 weeks. Twenty-three (10.41%) of these previously non-anemic pregnant women had clinical anemia after full-term pregnancy. Of the 23 women, 11 (47.83%) had iron-deficiency anemia, with serum ferritin less than 12 micrograms/l; another 11 women had some degree of iron depletion, with serum ferritin less than 20 micrograms/l. So in 22 of the 23 anemic women (95.65%) the cause of anemia may correlate to iron depletion. The remaining one had folate-deficiency anemia. No pure cobalamin deficiency anemia was found in this study. Among the 198 non-anemic normal full-term pregnant women, 92 (46.46%) had iron depletion (serum ferritin less than 20 micrograms/l), of whom 35 (17.68%) had severe iron deficiency, with serum ferritin less than 12 micrograms/l. Another 3 had folate deficiency and 3 had cobalamin deficiency. By including all the anemic and non-anemic pregnant women, 114 (51.58%) of them had some degree of iron depletion. In other words, pregnancy can produce a considerable degree of iron depletion in more than half of the previously non-anemic women.

Topics: Adult; Anemia; Anemia, Hypochromic; China; Female; Ferritins; Folic Acid; Folic Acid Deficiency; Humans; Pregnancy; Pregnancy Complications, Hematologic; Vitamin B 12; Vitamin B 12 Deficiency

To investigate folacin concentrations in malaria during pregnancy, women attending a rural antenatal clinic in Kenya were studied. Low serum folacin values had poor specificity for low red blood cell (RBC) folacin concentrations. Multigravidae had lower mean serum folacin (p less than 0.03) and RBC folacin (p less than 0.001) values than primigravidae. Primigravidae had higher mean RBC folacin values than nulliparae (p less than 0.05). Although anemia was frequent, no evidence of neutrophil hypersegmentation was seen in blood smears of individuals with low RBC folacin or indeterminate cobalamin values. The unexpectedly high RBC folacin concentrations are probably related to P falciparum infection: during followup a significant decrease in both RBC and serum folacin activity occurred after chloroquine was administered. This decrease may be unrelated to a gestational effect (RBC folacin p less than 0.01; serum folacin p less than 0.025). The pathogenesis of high RBC folacin activity is discussed in relation to reticulocytosis as well as to a biochemical mechanism within the RBC.

Topics: Adolescent; Adult; Anemia; Erythrocyte Count; Erythrocytes; Female; Folic Acid; Follow-Up Studies; Humans; Kenya; Malaria; Parity; Plasmodium falciparum; Pregnancy; Pregnancy Complications, Hematologic; Pregnancy Complications, Infectious; Radioimmunoassay; Rural Health; Vitamin B 12

Physician response to a low serum cobalamin result was evaluated in 250 patients. In 42% of cases, no response whatsoever to the low level was found. In 24%, response was suboptimal. In only 34% of cases was management adequate from a diagnostic and therapeutic aspect. Moreover, 13% of all patients were treated with folic acid alone. In addition to the lack of attention to the bulk of cases that had subtle abnormalities or that were not truly cobalamin-deficient, many cases with typical findings of deficiency were ignored. It should also be noted that many truly deficient patients had quite atypical clinical and hematologic features, and the classic picture emphasized in textbooks probably applies mainly to late cases with florid manifestations. These findings raise disturbing questions about the medical management of cobalamin deficiency. They also touch on the more general issue of how physicians view and respond to laboratory abnormalities.

Topics: Adult; Anemia; Anemia, Pernicious; Female; Folic Acid; Humans; Leukopenia; Male; Middle Aged; Peer Review; Vitamin B 12; Vitamin B 12 Deficiency

We found in four of five pernicious anemia gastric juices a partly degraded R binder which was cobalamin specific and has an apparent molecular weight of 60-70,000 daltons. Twenty-nine to 74% (4.8-27.0 ng/ml) of the corrinoid binding capacity could not be blocked by cobinamide (a noncobalamin corrinoid). The fifth pernicious anemia gastric juice and five nonpernicious anemia gastric juices had minimal amounts of this binder (2.5 and 2.2 +/- 1.4 ng/ml). Scatchard analysis revealed that cobalamin-specific R binder has 1000-fold lower affinity for cobinamide than cobalamin. Increasing quantities of trypsin and/or chymotrypsin digested increasing amounts of saliva R binder and an increasing percentage of the remaining digest-resistant R binder acquired cobalamin specificity. Partly degraded R binder in pernicious anemia gastric juice was resistant to further proteolysis. Cobalamin-specific R binder, perhaps produced in vivo by the action of refluxed pancreatic enzymes on swallowed R would preferentially bind ingested and/or biliary cobalamin rather than analogue and thereby could play a role in hastening the development of cobalamin deficiency in pernicious anemia.

Topics: Anemia; Anemia, Pernicious; Chromatography, Gel; Cobamides; Gastric Juice; Humans; Intrinsic Factor; Molecular Weight; Pancreas; Receptors, Cell Surface; Saliva; Vitamin B 12

Topics: Anemia; Female; Humans; Iron; Obstetric Labor Complications; Pregnancy; Pregnancy Complications, Hematologic; Puerperal Disorders; Vitamin B 12

Haematological and parasitological investigations were carried out on apparently healthy subjects in a rural area of Natal. Anaemia was highly prevalent and of a moderate to severe degree (haemoglobin value less than 11,0 g/dl) in 42% of males and 52,5% of females. In 50% of subjects the anaemia was hypochromic and iron deficiency appeared to be the major contributing factor. However, failure to utilize iron, giving rise to hypochromia, was not excluded as a complicating factor. Subnormal serum vitamin B12 levels were found in some subjects, and this frequently coexisted with iron deficiency. The presence of parasites was not considered to have contributed to the production of anaemia. It was concluded that the anaemia was to a large extent nutritional in origin.

Topics: Adolescent; Adult; Aged; Anemia; Black or African American; Black People; Child; Female; Ferritins; Hemoglobins; Hookworm Infections; Humans; Iron; Male; Middle Aged; Parasitic Diseases; Rural Population; Schistosomiasis; Sex Factors; South Africa; Vitamin B 12

Topics: Anemia; Erythrocyte Aging; Erythrocyte Count; Female; Ferritins; Folic Acid; Gestational Age; Hematocrit; Hemoglobins; Humans; Pregnancy; Pregnancy Complications, Hematologic; Vitamin B 12

Topics: Anemia; Anemia, Hypochromic; Anemia, Sideroblastic; Female; Folic Acid; Humans; Vitamin B 12; Vitamin B 12 Deficiency

In 1969 a group of hunter-gatherer San were studied (Am J Clin Nutr 1971;24:229-42). Their state of hematological nutrition was excellent with a negligible incidence of iron, folate, or vitamin B12 deficiency. A genetically and linguistically similar San community who have been settled for the past 15 yr were the subjects of the present study. Anemia, due in the main to iron and/or folate deficiency, has become more common. Alcoholism has become rife in both sexes and all age groups. Our findings show that a settled lifestyle has resulted in a significant deterioration in the San's hematological nutrition.

Topics: Adolescent; Adult; Alkaline Phosphatase; Anemia; Botswana; Child; Ethnicity; Female; Folic Acid; gamma-Glutamyltransferase; Humans; Iron; Lactation; Life Style; Male; Menopause; Middle Aged; Namibia; Parasitic Diseases; Pregnancy; Social Change; Vitamin B 12

Haematological studies in a group of Gambian children with severe anaemia due to Plasmodium falciparum malaria revealed marked dyserythropoietic changes in erythroblasts and evidence of increased ineffective erythropoiesis. In some cases, the bone marrow also showed a few giant metamyelocytes and ring sideroblasts. The results of deoxyuridine suppression tests indicated that these haematological disturbances were not a consequence of vitamin B12 or folate deficiency within marrow cells.

Topics: Anemia; Bone Marrow; Child, Preschool; Deoxyuridine; DNA; Erythropoiesis; Folic Acid; Humans; Infant; Malaria; Plasmodium falciparum; Vitamin B 12

Comparative studies were carried out with dextrofer-100 with B12 and dextrofer-100 in terms of acute toxicity (albino mice), absorption (rabbits, pigs, and lambs), deposition of iron in the liver and spleen (rabbits, pigs, and lambs) and antianemic action (pigs and lambs). It was found that LD50 of dextrofer-100 with B12 at i/v introduction into 18-20-gram albino mice was 1750 mg Fe3+/kg body mass; with regard to toxicity it was shown to correspond to the British Veterinary Code. The toxicity of dextrofer-100, studied by the same test, was practically undeterminable. By the level of sideremia dextrofer-100 with B12 did not differ essentially from dextrofer-100 and was said to belong to preparations with rapid absorption. It was most rapidly absorbed in pigs, rabbits and lambs following next. It supplied enough iron to the reticuloendothelial organs--in pigs it was (on a percent basis) highest in the liver, and in lambs--in the spleen. In pigs on the 10th day following treatment with dextrofer-100 with B12 the liver was shown to have vitamin B12 5 times as much. By its antianemic effect at i/m application to newborn pigs and lambs dextrofer-100 with B12 did not differ essentially from dextrofer-100 (its action was negligibly broader), however, it was beneficial to the growth of pigs.

Topics: Absorption; Anemia; Animals; Drug Combinations; Drug Evaluation; Female; Iron; Iron-Dextran Complex; Liver; Male; Mice; Rabbits; Sheep; Spleen; Swine; Swine Diseases; Vitamin B 12

Topics: Anemia; Blood Transfusion; Glucocorticoids; Humans; Splenectomy; Vitamin B 12

The etiologic explanation of an anemia is important for the most effective therapy of that anemia. This may also define an underlying disease process. The etiology of the anemia can be achieved by appropriate use of the history, physical examination, and laboratory data. This information may be used to clarify the anemia, define a diagnosis, and direct appropriate therapy.

Topics: Anemia; Anemia, Hypochromic; Anemia, Macrocytic; Anemia, Sickle Cell; Blood Cell Count; Cytodiagnosis; Erythrocyte Indices; Erythrocyte Transfusion; Female; Ferrous Compounds; Hematologic Tests; Humans; Male; Physical Examination; Reticulocytes; Thalassemia; Vitamin B 12

A combined preparation, biofer, was studied, defining its clinical and pharmacological capacity. Featuring in its composition are: normal bovine gammaglobulin, 8.0 g; ferridextran (dextrofer-100), 32 cm2 (= 3.2 g Fe); cuprum sulfuricum, 0.32 g (= 0.08 Cu); Co chloride, 0.18 g (= 0.08 Co); cyancobalamin, 0.0032 g; and protein hydrolysate up to 100 cm3, at pH = 7.0-7.2. The local and total tolerance of animals for biofer was studied along with the acute toxicity, absorption, and retention in the body of test animals and calves as well as the antianemic action in albino mice and calves. It was found that at 4 degrees C to 8 degrees C the shelf life of biofer was 2 years. Its LD50 at subcutaneous injection to albino rats was 11.7 cm3/kg body mass. At the rate of 0.6 cm3/kg (i/m) rabbits did not manifest local and total intolerance; at 1.8 cm3/kg there was no local inflammation, however, a transient drop of appetite was seen; at 3 cm3/kg rabbits manifested intoxication with exitus. At i/m introduction to rabbits and calves biofer was more slowly absorbed than dextrofer-100. The liver and spleen of animals injected with biofer showed higher values for copper. In i/m application to anemic albino rats biofer showed a better antianemic effect than dextrofer-100. In calves it activated to a better extent both erythropoiesis and leukopoiesis.

Topics: Absorption; Anemia; Animals; Cattle; Cattle Diseases; Cobalt; Copper; Copper Sulfate; Drug Combinations; Drug Evaluation; Drug Evaluation, Preclinical; Drug Tolerance; Ferrous Compounds; gamma-Globulins; Iron-Dextran Complex; Male; Mice; Protein Hydrolysates; Rats; Rats, Inbred Strains; Vitamin B 12

The effect was followed up of dextrofer-100 and dextrofer-100 with B12 on the growth and fertility of minks. It was found that the i/m injection of dextrofer-100 at the rate of 0.5 cm3 per head (50 mg Fe3+), twice, at the interval of 45 days to a total of 45-day-old minks did not effect essentially their growth. The i/m application of dextrofer-100 with vitamin B12 at 0.5 cm3 per animal (50 mg Fe3+ and 40 mcg B12), singly in the beginning of the mating period to young female minks (at the age of 11 months) resulted in raising the number of offsprings from 3.4 to 4.68 (with impregnated females), and from 4.05 to 5.13 (with those that gave birth), and in lowering the number of those of the males that did not give birth as well as of those that gave birth but ate their offsprings. The weight of the obtained offsprings of the test and control males did not differ essentially between the age of 40 days and the age of 24 weeks.

Topics: Anemia; Animals; Body Weight; Drug Combinations; Drug Evaluation; Female; Fertility; Growth; Iron-Dextran Complex; Male; Mink; Pregnancy; Vitamin B 12

Topics: Aged; Anemia; Anemia, Macrocytic; Blood Cell Count; Blood Transfusion; Chlorambucil; Erythrocyte Indices; Hematocrit; Hematologic Diseases; Hemoglobins; Humans; Leukemia, Lymphoid; Middle Aged; Multiple Myeloma; Platelet Count; Polycythemia Vera; Reticulocytes; Thalassemia; Vitamin B 12

Typical features on the blood smear suggest the diagnosis in some types of anemia, such as the common microcytic anemias, megaloblastic anemias, and certain hemolytic anemias. Some laboratory tests used in anemia, particularly measurement of serum vitamin B12 and folate levels, may present problems in interpretation, which must be recognized if diagnostic errors are to be avoided. Normocytic anemias that are nonhemolytic, have no obvious cause, and are characterized by marked red cell changes on the blood smear should prompt careful investigation for malignancy or marrow fibrosis. Anemias are often multifactorial, and the diagnosis must be reevaluated after the apparent contributing causes have been treated. A number of "danger signs" in a patient with anemia point to the need for hematologic consultation.

Topics: Anemia; Anemia, Hemolytic; Anemia, Hypochromic; Anemia, Macrocytic; Bone Marrow Examination; Chronic Disease; Diagnosis, Differential; Folic Acid; Humans; Thalassemia; Vitamin B 12

Since physicians are routinely taught to review the peripheral blood smear results of all anemic patients, we analyzed the diagnostic value of the laboratory's blood smear reading and the incremental value of a physician's personal reading in anemic inpatients. Blood smear abnormalities, as reported by the laboratory and two hematologists, were poorly reproducible, with only five of the 11 types of abnormalities being more reproducible than could be expected by chance. The blood smear performed no better than RBC indices in detecting probable iron deficiency or low serum levels of folate or vitamin B12. In anemias not caused by deficiency states, the blood smear reading performed by the hospital laboratory provided unique information in 6% of the cases and helpful information in another 25%, but the additional reading performed by a hematologist never provided unique information and provided incremental helpful information in only 4% of the cases. The peripheral blood smears of all anemic inpatients should be read by the hospital laboratory, but in our hospital, a routine additional personal reading by a physician had limited incremental value and could be reserved for selected cases.

Topics: Anemia; Anemia, Hypochromic; Blood Cell Count; Clinical Laboratory Techniques; Erythrocyte Indices; Erythrocytes; Erythrocytes, Abnormal; Evaluation Studies as Topic; Female; Folic Acid; Hematocrit; Hematologic Tests; Humans; Male; Probability; Vitamin B 12

Topics: Aged; Aging; Alcoholism; Anemia; Anemia, Aplastic; Anemia, Hemolytic; Anemia, Hypochromic; Anemia, Macrocytic; Anemia, Pernicious; Animals; Blood Cell Count; Drug-Related Side Effects and Adverse Reactions; Female; Ferrous Compounds; Folic Acid; Folic Acid Deficiency; Gastrointestinal Hemorrhage; Humans; Male; Mice; Reference Values; Vitamin B 12

Topics: Adolescent; Adult; Aged; Anemia; Female; Humans; Male; Middle Aged; Primary Health Care; Sweden; Vitamin B 12

Topics: Anemia; Female; Ferritins; Fetal Blood; Folic Acid; Hemoglobins; Humans; Infant, Newborn; Iron; Maternal-Fetal Exchange; Pregnancy; Pregnancy Complications, Hematologic; Vitamin B 12

The incidence of macrocytosis, defined as a mean corpuscular volume (MCV) of greater than 95 fl and large red cells on peripheral blood film, was determined in 303 alcoholics with liver disease (95 females: 208 males), 60 non-alcoholics with chronic liver disease (44 females: 16 males) and 35 control subjects (15 females: 20 males). Macrocytosis was found in 70.3% (213/303) of alcoholics with liver disease and in 23.3% (14/60) of non-alcoholics with liver disease, P less than 0.001. MCV values greater than 100 fl were seen in 49.5% (150/303) of alcoholics, but in only 3.3% (2/60) of non-alcoholics, P less than 0.001. Macrocytosis was more frequent in female, 86.3% (82/95) than in male alcoholics 63.0% (131/208), P less than 0.001. Serum folate values less than 3 microgram/l were found in 14.5% (44/303) of alcoholics and in 11.7% (7/60) of non-alcoholics. Low serum folate values were found in 18.3% (39/213) of alcoholics with macrocytosis and in 35.9% (28/78) of those with macrocytic anaemia. Twenty alcoholics with pre-cirrhotic liver disease were followed over three months. Macrocytosis was present in 85.0% (17/20) at the outset and in 40% (8/20) 3 months later. The changes in MCV were independent of alcohol intake and serum folate values. Macrocytosis is a useful diagnostic indicator of alcoholism. MCV values greater than 100 fl in patients with liver disease almost invariably indicate alcohol-related disease. In the short-term, changes in MCV are of little use in monitoring alcohol intake.

Topics: Anemia; Erythrocytes, Abnormal; Female; Folic Acid; Follow-Up Studies; Humans; Liver Diseases, Alcoholic; Male; Middle Aged; Vitamin B 12

Topics: Anemia; Drug Therapy, Combination; Humans; Neoplasms; Pyridoxine; Thiamine; Vitamin B 12; Vitamin B Complex; Vitamins

Maternal blood and milk iron (Fe), folate (FA), vitamin B12 (B12) and serum ferritin (Fr) were determined in four groups of lactating mothers: normal, toxemic, anemic and treated anemic during pregnancy. 1. An increasing blood Fe, Fr and a decreasing milk Fe with time in postpartum were found in each group. A high level of blood Fe, Fr was observed in the treated group. Milk Fe, however, had showed no significant difference in either group. There was no correlation between the blood and milk Fe. 2. There was no demonstrable change of blood FA, but milk FA had significantly increased in each group. Blood FA showed a low level in the toxemic group and a high level in the treated group, but no significant difference of milk FA could be found in either group. No matter how widely the level of blood FA spread, there was a little change in milk FA. 3. An increasing blood B12 and a decreasing milk B12 were found in each group. There was a tendency towards a high level of blood B12 in the treated group, but the level of milk B12 differed widely from one material to the other. There was no correlation between the blood and milk B12.

Topics: Anemia; Female; Ferritins; Folic Acid; Humans; Iron; Milk, Human; Postpartum Period; Pre-Eclampsia; Pregnancy; Pregnancy Complications, Hematologic; Vitamin B 12

Erythropoietin (ESF) titers were determined in sera from patients with different types of anemia using the fetal mouse liver cell bioassay. An inverse relationship was found between hemoglobin concentration and ESF titer. However, ESF titers differed markedly between patients at comparable degrees of anemia. Several groups of patients were distinguished on the basis of the activity of their erythroid bone marrow. In each of these groups, a significant negative correlation was found between the hemoglobin concentration and the logarithm of the ESF titer. ESF titers in patients with pure red cell aplasia were fourfold higher than those in patients with iron-deficiency anemia and tenfold higher than those in patients with megaloblastic anemia and homozygous sickle cell anemia at comparable hemoglobin concentrations. Following the initiation of specific therapy in patients with pernicious anemia and patients wit iron-deficiency anemia, serum ESF titers were found to decrease prior to any substantial rise in hemoglobin concentrations. In the patients with pernicious anemia, the lowest ESF levels were found 1 day after administration of vitamin B12, whereas in the patients with iron-deficiency anemia, the lowest ESF levels were reached in the second week of oral iron therapy. ON the basis of these data it was concluded that serum ESF titers in anemic patients are not only inversely related to the hemoglobin concentration but also to the activity of the erythroid bone marrow.

Topics: Anemia; Anemia, Hypochromic; Anemia, Pernicious; Animals; Bone Marrow Cells; Erythrocyte Count; Erythropoietin; Female; Hemoglobins; Humans; Iron; Mice; Mice, Inbred Strains; Pregnancy; Reticulocytes; Vitamin B 12

Topics: Adolescent; Anemia; Child; Child, Preschool; Female; Folic Acid; Hematocrit; Hemoglobins; Humans; Infant; Iron; Male; Vitamin B 12

The facts known today about the occurrence and possible mechanisms of anaemias caused by medicaments are represented in a survey. In this connection toxic haemolytic anaemias, immunohaemolytic anaemias, toxic aplastic anaemias, megaloblastic anaemias, and some other, more rarely occurring types are referred to.

Topics: Alcoholism; Anemia; Anemia, Aplastic; Anemia, Hemolytic; Anemia, Hemolytic, Autoimmune; Anemia, Megaloblastic; Anemia, Sideroblastic; Antitubercular Agents; Benzenesulfonates; Bone Marrow; Chloramphenicol; Chromosome Aberrations; Contraceptives, Oral, Hormonal; Folic Acid Antagonists; Gastrointestinal Hemorrhage; Humans; Preleukemia; Purines; Pyrimidines; Vitamin B 12

Two aboriginal communities situated in the tropical north-west of the Australian continent have been investigated in regard to trace metal status (zinc, copper, and iron) and other laboratory and epidemiological information. A total of 364 persons, ranging in age from 5 to 77 years were studied. The incidence of hypozincemia (serum or plasma zinc concentration less than 0.71 micrograms/ml) of the two communities when combined was 24.4%, while hypercupremia (defined as serum or plasma copper levels greater than 1.38 micrograms/ml) was 47.9%. Depressed serum iron levels were demonstrated in more than 50% of the Aborigines studied. Hypozincemia was most prevalent (incidence 31 to 67%) in children at the time of the important pre- and postadolescent growth period (10 to 15 years) and in women beyond 60 years of age (incidence 33 to 64%). Serum total protein and vitamin B12 levels tended to be increased. Mild anemia was seen in approximately one in five persons aged less than 20 years. Intestinal parasites and pathogenic enterobacteria were frequently isolated in fecal specimens. In one community, half of the persons examined had positive isolates of enteric pathogens. Intestinal parasites predominated and were more frequently isolated from persons aged less than 20 years. Ancylostoma duodenale accounted for 32% of the pathogens isolated. Evidence is presented that suggests that both communities are exposed to numerous bacterial, viral, and parasitic infections. The diet consumed in these communities is predominately white flour and refined sugar. Geophagia is practiced in this area of Australia. It is emphasied that all the etiological prerequisites and many of the laboratory findings ascribed to the zinc deficiency syndrome appear to be operating in the two Aboriginal communities studied.

Topics: Adolescent; Adult; Age Factors; Aged; Alkaline Phosphatase; Anemia; Australia; Blood Proteins; Child; Child, Preschool; Copper; Diet; Female; Humans; Iron; Male; Middle Aged; Native Hawaiian or Other Pacific Islander; Parasitic Diseases; Serum Albumin; Sex Factors; Vitamin B 12; Zinc

Topics: Anemia; Animals; Female; Gastrectomy; Growth Disorders; Iron; Stomach; Swine; Vitamin B 12

Surviving macroreticulocytes are released to peripheral blood during the first 4 d following a B12 injection to vitamin B12 deficient patients with grave anaemia. Marked increase in number of reticulocytes, together with corresponding reduction in reticulocyte size is noted in the top layer of the centrifuged packed red column from d 4 to 6 after medication. This 'remodelling' of the 'stress-reticulocytes' seems best explained by a division of the cells into 2 equal, surviving, normal-sized reticulocytes. The macroreticulocytes, which probably result from skipped division in the marrow, may thus complete their last cytoplasmatic division in the peripheral blood. The numerous schistocytes, which are found in the top layer of the centrifuged packed red cell column, disappear during the first few days after treatment, and it is assumed that these cells are fragments from the relatively few megalocytes which have reached the peripheral blood prior to medication. Macroreticulocytes seem to have a maximum deformability on d 5 after the B12 injection, shortly after the cell division has started.

Topics: Anemia; Cell Division; Erythrocyte Aging; Erythrocyte Count; Erythrocyte Indices; Hematocrit; Humans; Reticulocytes; Time Factors; Uric Acid; Vitamin B 12; Vitamin B 12 Deficiency

The anaemia in rheumatoid arthritis is apparently of complex origin, in which case an increased accumulation of iron in the RES and the decreased utilisation of storage iron play the quantitatively most important role. According to literary data megaloblastic anaemias shall not appear frequently in rheumatoid arthritis. The frequency of the anaemia is rheumatoid arthritis is clearly depending on the composition of the collective of patients. In our patients anaemia and hypoferraemia do not correlate with the actual activity of the disease, however with the extension of the affection of the joints and the progressing of the basic disease. Anaemia and hypoferraemia may, therefore, be valuated as prognostically unfavourable signs. We could prove decreased vitamin B12-levels in 11.6%. There was no statistically significant relation to the course of the disease. An inhibition of the resportion of vitamin B12 by means of a long-term therapy is discussed.

Topics: Anemia; Arthritis, Rheumatoid; Hemoglobins; Humans; Iron; L-Lactate Dehydrogenase; Middle Aged; Vitamin B 12

Topics: Adolescent; Adult; Aged; Anemia; Female; Folic Acid; Humans; Kidney Failure, Chronic; Male; Middle Aged; Prospective Studies; Renal Dialysis; Vitamin B 12

There are age-related changes in the results of some tests, but in none is the normal value for the elderly sufficiently different from normal values for younger adults to permit the physician confidently to ascribe an abnormal result to age alone. In assessing the significance of abnormal results of hematologic tests in asymptomatic patients, it is particularly important to consider problems of major import, such as blood loss from the gastrointestinal tract. Anemia is the abnormality most likely to be encountered, and investigation of a marginal reduction in the hemoglobin level of an elderly patient may be rewarded with a specific diagnosis of a disease that can be effectively treated, at least for a time.

Topics: Adult; Aged; Aging; Anemia; Blood Cell Count; Blood Sedimentation; Erythrocyte Indices; Female; Folic Acid; Hematologic Tests; Hematopoiesis; Hemoglobins; Humans; Iron; Leukocyte Count; Male; Middle Aged; Vitamin B 12

Topics: Anemia; Folic Acid; Humans; Iron; Vitamin B 12

The prevalence and causes of anemia have been studied in 104 patients over 60 years of age admitted to a general medical ward in Jerusalem. In males and females, mean hemoglobin levels were about 1 g less than in the corresponding groups of healthy younger controls. A primary nutritional anemia could not be implicated in any of the 15 patients with hemoglobins below 11 g/dl. The most important causes of anemia were chronic renal failure, metastatic carcinoma, gastrointestinal bleeding, and infection. Conversely, in diseases with no adverse effect on erythropoiesis such as chronic ischemic heart disease, hypertension and diabetes, hemoglobin levels were equal to those of the younger controls. These findings indicate that although diminished serum iron and RBC folate levels may occasionally be found in elderly subjects, nutritional deficiency is seldom responsible for anemia in this age group in Israel- and anemia when present is often the manifestation of a chronic underlying disease.

Topics: Adult; Aged; Anemia; Female; Folic Acid; Gastrointestinal Hemorrhage; Hemoglobins; Hospitalization; Humans; Infections; Iron; Iron Deficiencies; Israel; Kidney Diseases; Male; Middle Aged; Vitamin B 12

A new isomeric form of cobalamins is reported. The conversion of cobalamin to cobalamin (the new form) is achieved by substituting the benzimidazole base by a less bulky group like H2O or CN- and modest thermal treatment. The back conversion of adenosylcobalamin to the corresponding regular form occurs in the "base-off" form at room temperature. It seems that the corrin ring becomes quite flexible in the "base-off" form and the freer axial movement of the cobalt atom flips the corrin ring into a different conformation. The change in conformation is borne out by subtle changes in the proton magnetic resonances on the corrin ring and the base, and very marked variation in the emission Mössbauer spectra. The latter is indicative of appreciable changes in the spatial conformation in the immediate vicinity of the central metal atom. The ultraviolet-visible and infrared spectra of cobalamin are indistinguishable from those of its corresponding regular form. The new conformational isomeric species is present as an impurity in all commercially available cobalamins (including pharmaceutical preparations). It raises the question whether the cobalamins' constitute the real biologically active anti-anemic factor in humans.

Topics: Anemia; Chemical Phenomena; Chemistry; Chromatography, Thin Layer; Magnetic Resonance Spectroscopy; Models, Molecular; Molecular Conformation; Photolysis; Protons; Spectrophotometry; Vitamin B 12

Twenty-seven cases of long-term survival after total gastrectomy were clinically evaluated. From the standpoint of general nutrition and rehabilitation, the patients appeared to be in satisfactory condition. However, hyperchromic anemia, serum vitamin B12 deficiency, and osteoporosis were noted in some patients.

Topics: Adult; Aged; Anemia; Body Weight; Bone and Bones; Gastrectomy; Humans; Japan; Middle Aged; Nutritional Physiological Phenomena; Osteoporosis; Postgastrectomy Syndromes; Postoperative Care; Radiography; Stomach Neoplasms; Vitamin B 12

Topics: Anemia; Bacterial Infections; Humans; India; Intestine, Small; Puerto Rico; Sprue, Tropical; Vitamin B 12

Various factors led to delays of several months to several years in the diagnosis of pernicious anemia in 11 patients, occasionally with serious consequences. These cases illustrate that earlier diagnosis is possible with closer attention to abnormal results of common tests. Macrocytosis, detected by high mean corpuscular volume, often preceded anemia but was not investigated, especially when anemia was only slight. Several cases demonstrated that vitamin B12 deficiency may initially produce only a mild macrocytic anemia, which is maintained for a long period before a rapid worsening supervenes; the reason for the latter acceleration of anemia is unknown. Most serious was the evidence that mild anemias are often ignored. Stricter attention to the established limits of normal hemoglobin values is required. These aspects of physician performance have implication for the recognition of all anemias.

Topics: Aged; Anemia; Anemia, Macrocytic; Anemia, Pernicious; Female; Humans; Male; Middle Aged; Vitamin B 12

36% of a total of chronic liver patients suffered from anaemia and 50.5% of patients affected with liver cirrhosis. In most cases the anaemias were normochrome and hypochrome or hyperchrome only in some cases. In analyzing possible single factors the reductions of vitamin B12 absorption could be made probable by means of the Schilling test and sometimes a folic acid deficiency in macrocyte anaemia with normal vitamin B12 absorption by determining the folic acid content in the serum and by successes of test treatment 82% of patients with liver cirrhosis showed a latent or manifest haemolysis. However, it was only in 1/3 of the patients with liver cirrhosis that the spleen turned out to be the place of an increased degradation of erythrocytes. In some cases an increased erythrocytoclasia into the liver could be identified. Predominantly, however, an increased degradation of erythrocytes in the total RHS had to be assumed. Twice an ineffective erythropoiesis could be found by ferrokinetic examinations. As a whole ferrokinetic examinations cannot be interpreted easily, because their static and dynamic values of iron transport in the plasma volume of liver patients will undergo considerable changes. Patients with disturbances of haematopoiesis and with haemolysis remaining in the latent stage may develop a manifest anaemia because of the influence of additional factors, such as increase of the plasma volume at lowered haematocrit value or microbleedings. The cause of anaemia cannot be concluded with sufficient probability from the type of anaemia; in a single case all pathogenetic factors will rather have to be analyzed. Therapeutic possibilities for hepatogenous anaemia of complex genesis are discussed.

Topics: Adult; Anemia; Chronic Disease; Erythrocyte Count; Erythrocyte Volume; Folic Acid; Hematocrit; Humans; Liver Cirrhosis; Liver Diseases; Liver Neoplasms; Neoplasm Metastasis; Vitamin B 12

Topics: Anemia; Antineoplastic Agents; Erythropoiesis; Humans; Hypersplenism; Leukemia, Myeloid; Vitamin B 12

Topics: Alloys; Anemia; Animals; Beer; Cobalt; Enzyme Inhibitors; Food Contamination; Heart Diseases; Heme; Humans; Hyperlipidemias; Iron; Joint Prosthesis; Lipids; Neoplasms; Tissue Distribution; Vitamin B 12

After introductory remarks on the physiology of blood during pregnancy the authors enter the two most frequent anaemias of pregnancy, which are evoked by iron deficiency and infection, as well as the megaloblastic, which are evoked by deficiency of folic acid--more infrequently also by deficiency of vitamin B12. The diagnostic and therapeutic principles are described in detail. It is only in short referred to the very rare haemolytic and toxic farms of anaemia, it is generally renounced to describe the haemorrhagic anaemia. A prophylaxis of the anaemia of pregnancy is intensely recommended.

Topics: Anemia; Anemia, Megaloblastic; Female; Folic Acid; Humans; Iron; Iron Deficiencies; Pre-Eclampsia; Pregnancy; Pregnancy Complications, Hematologic; Vitamin B 12

Topics: Adult; Anemia; Hematocrit; Hemoglobins; Hookworm Infections; Humans; Iron; Male; Military Medicine; Thailand; Vitamin B 12

On the basis of general haematological, clinicochemical, cytomorphological, cytochemical and nuclearmedical investigations the anaemia of chronic haemodialysis can be considered as a renal anaemia modified by a permanent dialysis. It is less characterized by lack of erythropoietin, but more by a strong lack of iron, moderate haemolysis and slight deficiency of folic acid. After gradual diagnostics the substitution treatment with iron is absolutely necessary, medication of folic acid should be attempted. A permanent therapy with 80-120 mg of iron weekly administered parenterally can be successfully performed and 10-15 mg of folic acid daily, which will markedly lower the rate of transfusion.

Topics: Anemia; Blood Transfusion; Cell Survival; Erythropoiesis; Folic Acid; Humans; Iron; Renal Dialysis; Vitamin B 12

To investigate the role of folic acid deficiency in the pathogenesis of anemia in the elderly, hematological examinationa and assays of serum iron, vitamin B12 and folate were carried out on the 86 elderly patients admitted to a home for the aged. Means of red blood cell counts, hemoglobin levels and hematocrit were 385.3 x 10(4)/mm3, 12g/dl and 36%, respectively. These levels were lower than any other report in Japan. Anemia was detected in 23 out of 86 patients. Judging from mean corposcular volume and mean corposcular hemoglobin, most of them were normocytic and normochromic. Although low serum levels of iron and folate were rather frequently observed, the results on hematological examinations suggest that deficiency of these factors alone is not the cause of the anemia in the elderly patients. Rapid clearance of 5-methyl-tetrahydrofolic acid and increased excretion of formiminoglutamic acid after histidine loading were revealed in some of those who had subnormal serum folate levels. Therefore, supplementation of folic acid is recommended to those who had poor dietary intake.

Topics: Aged; Anemia; Blood Cell Count; Female; Folic Acid; Folic Acid Deficiency; Hematocrit; Hemoglobins; Humans; Iron; Male; Vitamin B 12

During 1 year 725 consecutive patients admitted to a geriatric unit were investigated for anaemia. 51% of men had haemoglobin levels below 13.5 g/dl and 41% of women had levels below 12 g/dl. 657 patients had an azuresin tubeless test meal following an augmented dose of histamine acid phosphate and 450 (68%) had achlorhydria. Gastric biopsies were performed on 240 of the patients with achloryhdria and 201 satisfactory biopsies were obtained. These were graded into five categories: (1) normal; (2) surface gastritis; (3) diffuse gastritis; (4) chronic atrophic gastritis, and (5) chronic atrophic gastritis with intestinal metaplasia. The grades of mucosal change could not be correlated with the presence or absence of anaemia, the state of gastric function as measured by the Schilling test for absorption of vitamin B12, or the level of vitamin B12 in the serum.

Topics: Achlorhydria; Age Factors; Aged; Anemia; Female; Gastric Juice; Gastric Mucosa; Gastritis; Humans; Male; Schilling Test; Vitamin B 12

Topics: Adolescent; Adult; Anemia; Bone Marrow Diseases; Female; Humans; Leukemia; Liver Diseases; Male; Vitamin B 12

Topics: Anemia; Duodenum; Gastrectomy; Humans; Hydrochloric Acid; Postgastrectomy Syndromes; Vitamin B 12

Topics: Anemia; Anemia, Hypochromic; Anemia, Macrocytic; Anemia, Pernicious; Ascorbic Acid; Bone Marrow Diseases; Female; Humans; Iron; Male; Pyridoxine; Vitamin B 12

In 11 patients with megaloblastic anemia, transfusion of packed erythrocytes or washed erythrocytes invariably resulted in a decline in plasma iron concentration to a range of 20-90 microgram/dl (3.6-16 mumol/l) after 36 to 48 hours. The same phenomenon was observed in two of six cases of ineffective erythropoiesis without megaloblastosis and in none of five cases of aplastic anemia. The observed changes did not result from a specific hematinic response or from iron uptake by a non-erythroid compartment. In megaloblastic anemia, alteration in marrow function in response to transfusion was reflected by plasma iron kinetics and serum lactate dehydrogenase values, which indicated marked reductions in both marrow hyperplasia and ineffective erythropoiesis. Transfusion in megalobastic anemia was also responsible for a 50% reduction in platelet count after 2 to 6 days. The significance of these changes is discussed.

Topics: Adult; Aged; Anemia; Anemia, Aplastic; Anemia, Macrocytic; Anemia, Megaloblastic; Blood Cell Count; Blood Platelets; Blood Transfusion; Female; Folic Acid; Humans; Iron; L-Lactate Dehydrogenase; Male; Middle Aged; Reticulocytes; Vitamin B 12

The non-heme iron, folates, and vitamin B12 in the liver of 77 fetuses were assayed as were serum levels of these metabolites in 70 of their mothers. The findings indicate the existence of independent placental transport mechanisms, switched on and off at different stages of late gestation, and peculiar to each metabolite.

Topics: Anemia; Female; Fetus; Folic Acid; Humans; Iron; Liver; Nutritional Physiological Phenomena; Pregnancy; Pregnancy Trimester, Second; Vitamin B 12

A prospective study of the clinical significance of macrocytosis (mean corpuscular volume 100 fL or more) was carried out for 9 months in a teaching hospital in 1975. Of the 140 patients with macrocytosis at the time of admission (0l7% of all hospital admissions) 46 (33%) had low activity of serum or erythrocyte folate, or both, and 16 (11%) had low serum vitamin B12 concentrations. Among the 78 patients with normal B12 and folate values the most commonly associated significant clinical conditions were alcoholism or hepatic disease (36 patients), malignant disease or the effects of chemotherapy (25 patients) and chronic obstructive lung disease (10 patients).

Topics: Adolescent; Adult; Aged; Alcoholism; Anemia; Erythrocyte Volume; Erythrocytes; Female; Folic Acid; Hemoglobins; Humans; Liver Diseases; Lung Diseases, Obstructive; Male; Middle Aged; Neoplasms; Vitamin B 12

Topics: Anemia; Animals; Female; Folic Acid; In Vitro Techniques; Liver; Methionine; Rats; Selenium; Tissue Distribution; Vitamin B 12

The incidence of anemia after total gastrectomy has not received sufficient clinical emphasis. During a follow-up period averaging 32 months, postresectional anemia developed in seven of ten patients without evidence of malignant neoplasm; all but one of these patients had received parenterally administered cyanocobalamin. Despite low levels of circulating erythrocytes and proportionately increased erythropoietin levels, reticulocytosis was not evident. This observation suggests an uncharacterized failure of marrow erythyroid precursors. Multiple deficits in intake of constituents necessary for the production of erythrocytes were demonstrated. With the possible exception of iron, malabsorption of these constituents is not an important factor in the production of anemia. Postresectional anemia is multicausal, but is primarily nutritional. As total gastrectomy becomes more commonly employed in the treatment of nonmalignant conditions, recognition of the frequency and causes of postresectional anemia should assist both diagnostic anticipation and therapy.

Topics: Adult; Aged; Anemia; Female; Folic Acid Deficiency; Gastrectomy; Humans; Intestinal Absorption; Iron; Male; Middle Aged; Vitamin B 12

Topics: Anemia; Anemia, Aplastic; Anemia, Sideroblastic; Diagnosis, Differential; Folic Acid; Humans; Vitamin B 12

Only a small proportion of patients with carcinoma of the stomach are suitable for radical surgery. For the remainder symptomatic treatment and radiotherapy alone or in combination with chemotherapy can be used to relieve distressing symptoms of pain, nausea and vomiting, and severe anemia. In the case of radiotherapy or chemotherapy, a degree of tumor regression can be expected. There have been encouraging results recently in palliating this disease with new radiotherapy techniques, notably fast neutron irradiation.

Topics: Analgesics; Anemia; Antacids; Carbenoxolone; Cortisone; Dexamethasone; Diet Therapy; Fast Neutrons; Humans; Iron; Parasympatholytics; Stomach Neoplasms; Vitamin B 12

Topics: Adult; Anemia; Blood Proteins; Humans; Malabsorption Syndromes; Serum Albumin; Transcobalamins; Vitamin B 12

Topics: Anemia; Female; Humans; Pregnancy; Pregnancy Complications, Hematologic; Thailand; Vitamin B 12

In an unselected series of 202 patients with hypothyroidism anaemia was present on diagnosis in 39 of 172 women and 14 of 30 men. Microcytic anaemia was present in only nine patients in the entire series. The average of the mean corpuscular volume (MCV) of all the patients was 90 fl. Fifty-three of 118 patients who were studied in detail had normal serum concentrations of vitamin B12, folic acid and iron. The haemoglobin was low in 13 of these 53 patients and rose on treatment with thyroxine alone. The MCV exceeded 90 fl in 29 of these 53 patients and in three it was greater than 100 fl. The MCV invariably fell on treatment with thyroxine even if the initial value was within the normal range. Nine of this group of 53 patients had both anaemia and an increased MCV--the macrocytic anaemia of hypothyroidism. A minor degree of anisocytosis of the red blood cells, which was reduced by treatment with thyroxine, was also demonstrated. Acanthocytes were present in the blood films of 32 out of 172 patients but in only five did the abnormal cells comprise more than 0-5 per cent of the red cell population. The incidence of new cases of pernicious anaemia diagnosed concurrently with the hypothyroidism in the carefully studied group of 118 patients was 8-5 per cent. The MCV of hypothyroid patients with low levels of vitamin B12 was often no greater than in patients with uncomplicated hypothyroidism. The MCV is not therefore a useful discriminant in the diagnosis of pernicious anaemia in hypothyroidism. The serum iron concentration was less than 12 mumol/1 in 60 out of 118 patients. The total iron binding capacity of the serum was increased in only 21 of these 60 patients. In 42 hypothyroid patients the low serum iron concentration was not associated with low levels of either vitamin B12 or folate and of these patients 22 were anaemic. Despite the very low percentage saturation of the iron binding capacity in all of these patients with a low serum iron, a lack of iron did not seem to be the usual determinant of anaemia when it occurred.

Topics: Acanthocytes; Adolescent; Adult; Aged; Anemia; Anemia, Pernicious; Erythrocyte Count; Female; Folic Acid; Hemoglobins; Humans; Hypothyroidism; Iron; Male; Middle Aged; Vitamin B 12

Topics: Adult; Aged; Anemia; Child, Preschool; Female; Humans; Malabsorption Syndromes; Male; Middle Aged; Neurologic Manifestations; Vitamin B 12; Vitamin B 12 Deficiency

Hb and PCV values were studied in three groups of Addis Ababa women during their last month of pregnancy and compared with those in a control group of non-pregnant Addis Ababa women. Irrespective of socio-economic group and parity, the Hb and PCV values were almost identical in all four groups. In one of the three test groups, a group of 'non-privileged' multiparae, S-iron, S-transferrin (TIBC), S-folate and S-vitamin B12 were also examined and showed normal values. These findings indicate a rarity not only of true anaemia but also of 'physiological anaemia of pregnancy'. This latter may not, therefore, be an adaptive phenomenon of regular occurrence as has usually been assumed hitherto. The explanation for the aberrant haematological behavior in pregnant women living in highland Ethiopia is probably the lifelong exposure to a very high iron intake combined with hypoxia due to the high altitude.

Topics: Adolescent; Adult; Anemia; Ethiopia; Female; Folic Acid; Food Analysis; Hematocrit; Hemoglobins; Humans; Iron; Pregnancy; Pregnancy Complications, Hematologic; Transferrin; Vitamin B 12

A review has been carried out of patients diagnosed as having coeliac disease some years previously and subsequently lost to follow-up. Most were unaware of the need for continuing treatment and had returned to a normal diet. The resulting morbidity was slight, although one patient had died of a small-bowel lymphoma. If untreated coeliac disease is indeed a pre-malignant condition, then it is suggested that there must be a large population at risk, with no motivation to return to treatment other than the risk of malignancy itself.

Topics: Adolescent; Adult; Anemia; Blood Proteins; Body Constitution; Celiac Disease; Child; Female; Folic Acid; Follow-Up Studies; Glutens; Hemoglobins; Humans; Intestinal Neoplasms; Iron; Jejunum; Lymphoma; Magnesium; Male; Precancerous Conditions; Vitamin B 12

The observations on seventy patients with migratory glossitis and follow-up experiences over a period of 10 years are recorded. Women represented 65.7 per cent of the total, and most cases occurred in patients over 40 years of age. In 20 per cent of the patients other anomalies of the tongue were associated, and in 20 per cent subjective complaints were associated with psychic stress. Histologic investigations showed an inflammatory reaction of the epithelium and of the underlying connective tissue. The patient must be reassured of the benign nature of the tongue lesion. At follow-up examination, the lesions were present but no malignant change was observed.

Topics: Acridines; Adolescent; Adult; Age Factors; Aged; Anemia; Antifungal Agents; Ascorbic Acid; Child; Child, Preschool; Female; Follow-Up Studies; Glossitis, Benign Migratory; Gonadal Steroid Hormones; Humans; Infant; Iron; Male; Middle Aged; Mouthwashes; Sex Factors; Time Factors; Vitamin A; Vitamin B 12; Vitamin B Complex

Topics: Adolescent; Adult; Age Factors; Aged; Anemia; Bone Marrow; Bone Marrow Cells; Bone Marrow Examination; Child; Child, Preschool; Erythrocytes; Erythropoiesis; Female; Folic Acid; Folic Acid Deficiency; Hemoglobins; Humans; Infant; Leukemia; Male; Megaloblasts; Middle Aged; Sex Factors; Transferrin; Vitamin B 12; Vitamin B 12 Deficiency

The occurrence of anemia in a group of aged persons residing in a home for the aged and in a chronic disease hospital was reviewed with regard to etiology, choice of treatment, and therapeutic response. Of the 484 patients, 151 (31 per cent) had anemia or were receiving antianemia therapy. Iron-deficiency anemia was the most common type, and iron was the most common form of treatment. Seventy-eight patients were given antianemia therapy in 97 courses, and a good therapeutic result was achieved in about one-fourth of the courses. The most frequent error in iron therapy was its use in the anemia associated with chronic disorders. Often there was a combination deficiency of iron, vitamin B12 and folic acid. The response to iron in the elderly can be very slow, so therapy should not be discontinued too soon. Anemia may directly contribute to other serious pathologic conditions, especially in aged persons with impaired circulation. In some cases the physiologic concentration of hemoglobin may be higher than the accepted "normal" value. The course of the anemia in relation to the general state of the patient is more significant than any laboratory data in choosing antianemia therapy. Practical laboratory screening procedures for elderly anemic patients are discussed.

Topics: Aged; Anemia; Anemia, Hypochromic; Anemia, Macrocytic; Anemia, Pernicious; Chronic Disease; Female; Folic Acid; Folic Acid Deficiency; Hemoglobins; Humans; Iron; Male; Vitamin B 12

Topics: Adolescent; Adult; Age Factors; Aged; Anemia; Anemia, Hypochromic; Australia; Child; Female; Folic Acid; Hemoglobins; Humans; Male; Middle Aged; Native Hawaiian or Other Pacific Islander; Pyridoxal; Sex Factors; Vitamin B 12

Topics: Anemia; Folic Acid; Humans; Infant, Newborn; Infant, Premature, Diseases; Iron; Vitamin B 12

The present study has examined the relationship and significance of hypocholesterolaemia to anaemia and to the red cell. The level of plasma cholesterol is closely related to haematocrit levels both initially and throughout the course of the anaemias associated with hypocholesterolaemia. The association is maintained, regardless of the cause of the haematocrit change, i.e. transfusion or response to treatment. Hypocholesterolaemia does not affect the red cell, i.e. its survival, cholesterol concentration or osmotic fragility and occurs in a diverse group of anaemias. As such, it is not causally related to anaemia. The changes in plasma cholesterol are most likely related to its 'redistribution' or to plasma 'dilution', with contributory factors occurring. The presence of anaemia, even to a modest degree, would be important to consider when comparing cholesterol levels between groups of individuals.

Topics: Anemia; Anemia, Aplastic; Anemia, Megaloblastic; Anemia, Sickle Cell; Blood Transfusion; Cholesterol; Erythrocyte Aging; Erythrocytes; Folic Acid; Hematocrit; Humans; Liver Cirrhosis; Osmotic Fragility; Spherocytosis, Hereditary; Splenectomy; Vitamin B 12

Topics: Aged; Alanine Transaminase; Alkaline Phosphatase; Analysis of Variance; Anemia; Aspartate Aminotransferases; Biological Assay; Drug Stability; Evaluation Studies as Topic; Female; Humans; Iron; Isotope Labeling; Lactobacillus; Male; Methods; Middle Aged; Time Factors; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Agricultural Workers' Diseases; Anemia; Anemia, Hypochromic; Anemia, Megaloblastic; Diet; Folic Acid; Hookworm Infections; Iron; Sanitation; Socioeconomic Factors; Sri Lanka; Vitamin B 12

Topics: Adolescent; Adult; Anemia; Anemia, Hypochromic; Blood Proteins; Deficiency Diseases; Erythrocytes; Female; Folic Acid; Glucosephosphate Dehydrogenase; Glucosephosphate Dehydrogenase Deficiency; Hematocrit; Hemoglobins; Humans; Intestinal Diseases, Parasitic; Iron; Iron Deficiencies; Lactation; Malaria; Male; Middle Aged; New Guinea; Pregnancy; Protein Binding; Sex Factors; Splenomegaly; Thalassemia; Vitamin B 12

Topics: Anemia; Blood Transfusion; Humans; Leukopenia; Neoplasms; Pyridoxine; Vitamin B 12

Topics: Administration, Oral; Adult; Anemia; Chronic Disease; Female; Humans; Intrinsic Factor; Malabsorption Syndromes; Male; Middle Aged; Pancreatitis; Schilling Test; Trypsin; Vitamin B 12

Topics: Anemia; Binding, Competitive; Biological Assay; Blood; Chromatography, DEAE-Cellulose; Cobalt Radioisotopes; Female; Glutamates; Hormones; Humans; Kinetics; Lactobacillus; Male; Pharmacology; Protein Binding; Radioligand Assay; Temperature; Time Factors; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Anemia; Anemia, Aplastic; Anemia, Hemolytic; Anemia, Hypochromic; Anemia, Megaloblastic; Anemia, Sideroblastic; Blood Transfusion; Diet Therapy; Female; Folic Acid; Humans; Iron; Kidney Diseases; Male; Postgastrectomy Syndromes; Pregnancy; Pregnancy Complications, Hematologic; Vitamin B 12

Topics: Acrylates; Adult; Anemia; Asthenia; Calcium; Chemical Phenomena; Chemistry, Physical; Creatinine; Female; Filtration; Humans; Kidneys, Artificial; Male; Membranes, Artificial; Middle Aged; Molecular Weight; Nitriles; Peritoneal Dialysis; Permeability; Polyneuropathies; Renal Dialysis; Succinates; Time Factors; Urea; Uremia; Uric Acid; Vitamin B 12

Topics: Adult; Aged; Anemia; Deficiency Diseases; Erythrocyte Count; Erythrocytes; Erythrocytes, Abnormal; Folic Acid; Folic Acid Deficiency; Follow-Up Studies; Gastrectomy; Hemoglobins; Humans; Iron; Leukocyte Count; Male; Middle Aged; Neutrophils; Postgastrectomy Syndromes; Protein Binding; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Adult; Anemia; Animals; Deficiency Diseases; Diet; Erythrocytes; Female; Folic Acid; Hemoglobins; Humans; Iron; Male; Milk; Nepal; Nutrition Surveys; Vitamin B 12

Topics: Anemia; Biopsy, Needle; Castration; Cholesterol; Diethylstilbestrol; Estrogens; Folic Acid; Hematuria; Humans; Iron; Lipoproteins; Lymph Nodes; Male; Neoplasm Metastasis; Prostatectomy; Prostatic Neoplasms; Prostatitis; Testosterone; Triglycerides; Uremia; Urination Disorders; Vitamin B 12

Topics: Anemia; Anemia, Hypochromic; Bilirubin; Electrophoresis; Folic Acid; Haptoglobins; Hemoglobins; Humans; Iron; L-Lactate Dehydrogenase; Transferrin; Vitamin B 12

Topics: Anemia; Bone Marrow; Chromium Radioisotopes; Erythrocytes; Erythropoiesis; Hemoglobins; Humans; Iron; Iron Radioisotopes; Liver; Myocardium; Spleen; Technetium; Vitamin B 12

Topics: Anemia; Bone Marrow Examination; Folic Acid; Hemolysis; Humans; Iron; Transferrin; Vitamin B 12

Topics: Anemia; Bone Marrow; Folic Acid; Hematocrit; Hemoglobins; Humans; Male; Vitamin B 12

Topics: Alcoholism; Anemia; Automation; Erythrocyte Count; Erythrocytes, Abnormal; Ethanol; Fatty Liver; Female; Folic Acid; Folic Acid Deficiency; Hematocrit; Hemoglobinometry; Humans; Liver Function Tests; Male; Mass Screening; Sex Factors; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Adult; Anemia; Blood Preservation; Erythrocytes; Female; Humans; Male; Middle Aged; Vitamin B 12

Topics: Adult; Anemia; Biopsy; Blind Loop Syndrome; Chronic Disease; Diarrhea; Gastrointestinal Hemorrhage; Humans; Intestinal Absorption; Intestinal Mucosa; Malabsorption Syndromes; Male; Radiography; Ulcer; Vitamin B 12

Topics: Anemia; Blood Proteins; Carrier Proteins; Chromatography, DEAE-Cellulose; Chromatography, Gel; Hepatitis; Humans; Leukemia, Myeloid; Vitamin B 12

Topics: Adult; Aged; Anemia; Deficiency Diseases; Erythrocytes; Folic Acid; Gastrectomy; Hematologic Diseases; Humans; Iron; Male; Middle Aged; Neutrophils; Transferrin; Vitamin B 12

Topics: Anemia; Blood Cell Count; Blood Platelets; Blood Proteins; Colitis, Ulcerative; Crohn Disease; Hemoglobins; Humans; Hypoproteinemia; Intestine, Large; Intestine, Small; Iron; Leukocyte Count; Leukocytosis; Schilling Test; Thrombocytosis; Vitamin B 12; Vitamin B 12 Deficiency

In a general medical hospital population the neurological status of 24 patients with severe folate deficiency was compared with that of a control group of 21 patients with normal serum folate. A significant increase of organic brain syndrome and pyramidal tract damage was found in the folate-deficient group. These findings were independent of the degree of anaemia or the presence of alcoholism. These data are consistent with the view that severe folate deficiency may cause neurological deficits.

Topics: Alcoholism; Anemia; Brain Diseases; Female; Folic Acid; Folic Acid Deficiency; Humans; Male; Middle Aged; Nervous System Diseases; Pyramidal Tracts; Reflex, Abnormal; Vitamin B 12

Topics: Anemia; Carrier Proteins; Chromatography, DEAE-Cellulose; Electrophoresis; Humans; Leukemia; Liver Diseases; Metabolic Clearance Rate; Molecular Weight; Mucoproteins; Myeloproliferative Disorders; Vitamin B 12

Topics: Anemia; Child; Child, Preschool; Deficiency Diseases; Erythrocytes; Female; Folic Acid; Humans; Infant; Iron; Male; Tetrahydrofolates; Transferrin; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Adolescent; Adult; Anemia; Anemia, Hypochromic; Child; Child, Preschool; Diagnosis, Differential; Female; Folic Acid; Folic Acid Deficiency; Humans; Infant; Infant, Newborn; Iron; Male; Nonprescription Drugs; Pregnancy; Substance-Related Disorders; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Adolescent; Adult; Anemia; Biopsy; Body Weight; Celiac Disease; Child; Chromium Isotopes; Crohn Disease; Fatty Acids; Female; Glucose Tolerance Test; Humans; Hypocalcemia; Hypoproteinemia; Intestinal Absorption; Intestinal Mucosa; Iron; Malabsorption Syndromes; Male; Proteins; Radiography; Rectum; Vitamin B 12; Xylose

Topics: Anemia; Anemia, Hypochromic; Anemia, Macrocytic; Diphosphoglyceric Acids; Erythrocytes; Folic Acid; Hemoglobins; Humans; Kinetics; Oxygen; Vitamin B 12

Topics: Anemia; Bone Marrow; Female; Folic Acid; Humans; Malabsorption Syndromes; Neutrophils; Postpartum Period; Pregnancy; Puerperal Disorders; Vitamin B 12

Topics: Anemia; Binding, Competitive; Blood Proteins; Cellulose; Cobalt Radioisotopes; Dextrans; Evaluation Studies as Topic; Humans; Intrinsic Factor; Isotope Labeling; Methods; Protein Binding; Radiochemistry; Regression Analysis; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Adult; Aged; Anemia; Anemia, Hypochromic; Erythrocytes; Folic Acid; Folic Acid Deficiency; Follow-Up Studies; Gastrectomy; Hematocrit; Humans; Iron; Male; Middle Aged; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Anemia; Animals; Dogs; Erythropoiesis; Erythropoietin; Iron; Polycythemia; Vitamin B 12

Topics: Adolescent; Anemia; Breast Feeding; Child; Child, Preschool; Female; Folic Acid Deficiency; Hemoglobins; Humans; Infant; Iron; Male; Transferrin; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Anemia; Anemia, Hypochromic; Anemia, Macrocytic; Anemia, Pernicious; Erythrocytes; Glutathione; Hemoglobinometry; Humans; Peroxidases; Time Factors; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Anemia; Calorimetry; Citrates; Depression, Chemical; Erythrocytes; Female; Hemoglobins; Heparin; Humans; Hydrogen-Ion Concentration; In Vitro Techniques; Male; Methods; Potassium; Reticulocytes; Temperature; Ultracentrifugation; Vitamin B 12

Topics: Adult; Age Factors; Aged; Anemia; Autoanalysis; Blood Proteins; Diet; Erythrocytes; Female; Folic Acid; Hemoglobins; Hospitalization; Humans; Iron; Male; Middle Aged; Nutrition Disorders; Nutrition Surveys; Protein Binding; Sex Factors; Vitamin B 12

Topics: Anemia; Blood Volume Determination; Female; Hemodynamics; Hemoglobinometry; Humans; Iron; Postpartum Period; Pregnancy; Pregnancy Complications, Hematologic; Vitamin B 12

Topics: Adolescent; Age Factors; Anemia; Anemia, Hypochromic; Ascariasis; Blood Proteins; Child; Deficiency Diseases; Female; Folic Acid; Folic Acid Deficiency; Hematocrit; Hemoglobinometry; Humans; Intestinal Diseases, Parasitic; Iron; Male; Philippines; Transferrin; Trichuriasis; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Anemia; Arthritis, Rheumatoid; Blood Proteins; Bone Marrow; Bone Marrow Cells; Chronic Disease; Erythropoietin; gamma-Globulins; Hematocrit; Humans; Infections; Iron; Neoplasms; Protein Biosynthesis; Serum Albumin; Transferrin; Vitamin B 12

Topics: Adult; Anemia; Contraceptives, Oral; Female; Humans; Pregnancy; Pregnancy Complications; Vitamin B 12

Topics: Adolescent; Adult; Agranulocytosis; Anemia; Anorexia Nervosa; Blood Platelet Disorders; Blood Volume; Bone Marrow; Bone Marrow Cells; Bone Marrow Diseases; Female; Folic Acid; Glycosaminoglycans; Hematopoiesis; Hemolysis; Humans; Iron; Lymphopenia; Starvation; Vitamin B 12

Topics: Anemia; Anemia, Hypochromic; Anemia, Macrocytic; Anemia, Pernicious; Blood Proteins; Female; Hematologic Diseases; Humans; Leukemia, Lymphoid; Leukemia, Myeloid; Leukemia, Myeloid, Acute; Leukocyte Count; Liver Cirrhosis; Lupus Erythematosus, Systemic; Lymphoma; Male; Multiple Myeloma; Neoplasms; Polycythemia; Primary Myelofibrosis; Protein Binding; Uremia; Vitamin B 12

Topics: Aged; Alkaline Phosphatase; Anemia; Blood Cell Count; Bone Marrow Examination; Female; Hematocrit; Hemoglobinometry; Humans; Karyotyping; Leukemia, Myeloid; Male; Middle Aged; Muramidase; Vitamin B 12

Topics: Agar; Anemia; Blind Loop Syndrome; Body Weight; Diet; Escherichia coli; Feces; Female; Gastrectomy; Gastroenterostomy; Hemoglobins; Humans; Indican; Intestine, Small; Iron; Lipids; Male; Peptic Ulcer; Postoperative Complications; Tryptophan; Vitamin B 12

Topics: Adolescent; Anemia; Child; Child, Preschool; Deficiency Diseases; Diet Therapy; Female; Folic Acid; Humans; Infant; Infant, Newborn; Iron; Male; Nutrition Disorders; Nutritional Requirements; Pregnancy; Vitamin B 12

Topics: Adolescent; Adult; Aged; Anemia; Anemia, Hypochromic; Anemia, Macrocytic; Bone Marrow; Bone Marrow Examination; Crohn Disease; Erythrocytes; Female; Folic Acid; Folic Acid Deficiency; Humans; Iron; Male; Middle Aged; Prospective Studies; Recurrence; Transferrin; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Anemia; Antihypertensive Agents; Humans; Hypertension; Iron; Vitamin B 12

Topics: Anemia; Autoantibodies; Cobalt Isotopes; Gastric Juice; Humans; Intrinsic Factor; Vitamin B 12

Topics: Adolescent; Adult; Anemia; Erythrocytes; Female; Folic Acid Deficiency; Humans; Liver; Pregnancy; Vitamin B 12

In pregnancy the level of serum vitamin B(12) is lower in women who smoke than in non-smokers. This finding occurs independently of social class, parity, or level of haemoglobin. In addition, the mean serum B(12) level tends to be less in women who are anaemic and is less in those women who have smaller babies. These findings may be an effect of the cyanide content of tobacco smoke, since cyanide may be detoxified by a mechanism which depletes the stores of vitamin B(12) in the body.

Topics: Anemia; Biotransformation; Birth Weight; Cyanides; Female; Gestational Age; Humans; Hypertension; Parity; Pre-Eclampsia; Pregnancy; Pregnancy Complications, Hematologic; Smoking; Social Class; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Cobalt Isotopes; Humans; Intestinal Absorption; Methods; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Adolescent; Adult; Aged; Anemia; Anemia, Hypochromic; Anemia, Macrocytic; Blood Proteins; Carbon Isotopes; Female; Folic Acid; Folic Acid Deficiency; Hemoglobins; Humans; Isomerases; Leukocyte Count; Leukocytes; Male; Malonates; Middle Aged; Neurologic Manifestations; Protein Binding; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Adult; Aged; Anemia; Asthenia; Body Weight; Cachexia; Chronic Disease; Cytidine; Diabetes Complications; Female; Heart Diseases; Humans; Hyperthyroidism; Liver Diseases; Liver Extracts; Male; Middle Aged; Nucleosides; Uridine; Vitamin B 12

Topics: Anemia; Anemia, Hypochromic; Anemia, Macrocytic; Asian People; China; Diet; Erythrocytes; Erythropoiesis; Ethnicity; Female; Folic Acid; Hemoglobinometry; Humans; India; Malaysia; Neutrophils; Parity; Pregnancy; Pregnancy Complications, Hematologic; Racial Groups; Singapore; Vitamin B 12; Vitamin B 12 Deficiency; White People

Topics: Amides; Anemia; Animals; Cricetinae; Dietary Carbohydrates; FIGLU Test; Folic Acid; Folic Acid Deficiency; Food Additives; Glutathione; Imidazoles; Liver; Rodent Diseases; Sex Factors; Sulfonamides; Vitamin B 12

Topics: Anemia; Child; Child, Preschool; Female; Humans; Infant; Infant, Newborn; Liver Diseases; Liver Extracts; Male; Nucleosides; Uridine; Vitamin B 12

Topics: Anemia; Anemia, Macrocytic; Bone Marrow; Erythrocytes; Female; Folic Acid; Folic Acid Deficiency; Hemoglobinometry; Humans; Iron; Neutrophils; Pregnancy; Pregnancy Complications, Hematologic; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Adult; Anemia; Anemia, Hypochromic; Anemia, Sideroblastic; Blood Cell Count; Female; Folic Acid; Gestational Age; Hematocrit; Hemoglobins; Humans; Iron; Nutrition Surveys; Philippines; Pregnancy; Pregnancy Complications, Hematologic; Socioeconomic Factors; Transferrin; Vitamin B 12

Topics: Adolescent; Adult; Aged; Anemia; Anemia, Hypochromic; Biliary Tract Diseases; Biometry; Cardiovascular Diseases; Erythrocyte Count; Erythrocytes; Erythrocytes, Abnormal; Female; Gastrointestinal Diseases; Hematologic Diseases; Hemophilia A; Humans; Leukemia; Liver Diseases; Lung Diseases; Male; Middle Aged; Neoplasms; Pancreatic Diseases; Splenectomy; Thalassemia; Thyroid Diseases; Urologic Diseases; Vitamin B 12

Topics: Adolescent; Adult; Alkaline Phosphatase; Anemia; Bone Marrow Examination; Busulfan; Chromosome Aberrations; Female; Humans; Leukemia, Myeloid; Leukocytes; Male; Middle Aged; Primary Myelofibrosis; Prognosis; Radiometry; Splenomegaly; Technetium; Thrombocytopenia; Vitamin B 12

Topics: Adolescent; Adult; Age Factors; Aged; Anemia; Antineoplastic Agents; Child; Child, Preschool; Diagnosis, Differential; Hematologic Diseases; Humans; Leukemia; Lymphadenitis; Middle Aged; Plasmacytoma; Prognosis; Vitamin B 12

Topics: Africa, Southern; Amebiasis; Anemia; Cooking and Eating Utensils; Diet; Feces; Female; Folic Acid; Folic Acid Deficiency; Giardiasis; Hematocrit; Hemoglobins; Hookworm Infections; Humans; Iron; Male; Nutrition Disorders; Pregnancy; Protein Binding; Transferrin; Trichomonas Infections; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Age Factors; Aged; Anemia; Anemia, Hypochromic; Anemia, Macrocytic; Anemia, Sideroblastic; Erythrocytes; Female; Folic Acid; Hemoglobins; Humans; Iron; Male; Sex Factors; Vitamin B 12; Wales

Topics: Adolescent; Adult; Anemia; Bone Marrow; Female; Folic Acid; Hemoglobinometry; Humans; Iron; Nutritional Physiological Phenomena; Pregnancy; Pregnancy Complications, Hematologic; Vitamin B 12

Topics: Acrylates; Adolescent; Adult; Aged; Aminosalicylic Acids; Anemia; Anemia, Hypochromic; Anemia, Macrocytic; Antitubercular Agents; Erythropoiesis; Female; FIGLU Test; Folic Acid; Folic Acid Deficiency; Humans; Imidazoles; Iron; Isoniazid; Male; Middle Aged; Streptomycin; Tuberculosis; Vitamin B 12

Topics: Agammaglobulinemia; Agranulocytosis; Anemia; Anemia, Hemolytic; Anemia, Hypochromic; Anemia, Macrocytic; Anemia, Sideroblastic; Antineoplastic Agents; Bone Marrow Diseases; Elliptocytosis, Hereditary; Female; Folic Acid; Folic Acid Deficiency; Humans; Iron; Myeloproliferative Disorders; Polycythemia Vera; Pregnancy; Primary Myelofibrosis; Spherocytosis, Hereditary; Thalassemia; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Anemia; Blood Proteins; Humans; Inflammation; Leukemia, Myeloid; Liver Diseases; Neoplasms; Protein Binding; Vitamin B 12

Topics: Adolescent; Adrenal Cortex Hormones; Anemia; Child; Child, Preschool; Diagnosis, Differential; Female; Gastrointestinal Hemorrhage; Hematocrit; Hemoglobins; Humans; Infant; Infant, Newborn; Iron; Male; Testosterone; Vitamin B 12

Topics: Anemia; Anemia, Macrocytic; Duodenal Ulcer; Female; Folic Acid; Folic Acid Deficiency; Hemoglobinometry; Humans; Jejunum; Male; Peptic Ulcer; Postgastrectomy Syndromes; Stomach Ulcer; Vagotomy; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Age Factors; Aged; Anemia; Anemia, Hypochromic; Arthritis, Rheumatoid; Blood Chemical Analysis; Blood Proteins; Blood Sedimentation; Bronchitis; England; Feces; Female; Folic Acid; Folic Acid Deficiency; Health Surveys; Hematologic Diseases; Hemoglobins; Hospitalization; Humans; Iron; Middle Aged; Neoplasms; Sex Factors; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Acidosis; Anemia; Blood Cells; Child, Preschool; Chromatography, Paper; Dietary Proteins; Humans; Infant; Infant, Newborn; Malonates; Metabolism, Inborn Errors; Vitamin B 12

Topics: Anemia; Blood Volume; Bone Marrow Examination; Child, Preschool; Folic Acid; Humans; Infant; Iron; Kwashiorkor; Vitamin B 12

Topics: Adolescent; Age Factors; Anemia; Blood Cell Count; Child; Child, Preschool; Female; Folic Acid; Folic Acid Deficiency; Hematocrit; Hemoglobins; Humans; Infant; Male; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Achlorhydria; Adult; Anemia; Anemia, Hypochromic; Anemia, Macrocytic; Blood Cell Count; Female; Folic Acid; Gastric Acidity Determination; Hematocrit; Humans; Iron; Pregnancy; Pregnancy Complications, Hematologic; Thalassemia; Urine; Vitamin B 12

Topics: Anemia; Humans; Malonates; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Anemia; Female; Humans; Intestinal Absorption; Intrinsic Factor; Middle Aged; Vitamin B 12

Topics: Anemia; Anticonvulsants; Biological Assay; Epilepsy; Folic Acid; Hemoglobins; Humans; Lactobacillus; Vitamin B 12

Topics: Anemia; Blood Volume Determination; Humans; Iodine Radioisotopes; Malabsorption Syndromes; Radioisotope Renography; Radioisotopes; Radionuclide Imaging; Thyroid Function Tests; Vitamin B 12

Topics: Anemia; Bilirubin; Blood Transfusion; Bone Marrow; Bone Marrow Cells; Erythropoiesis; Erythropoietin; Hematocrit; Humans; Leukemia, Erythroblastic, Acute; Leukocyte Count; Male; Middle Aged; Pneumonia; Reticulocytes; Vitamin B 12

Topics: Adolescent; Adult; Aged; Anemia; Anemia, Macrocytic; Anemia, Pernicious; Anemia, Sickle Cell; Celiac Disease; Cell Nucleus; Cheek; Epithelium; Fatty Liver; Female; Humans; Malabsorption Syndromes; Male; Microscopy; Middle Aged; Mouth Mucosa; Pregnancy; Pregnancy Complications, Hematologic; Thalassemia; Vitamin B 12

Topics: Anemia; Animals; Bartonella Infections; Cat Diseases; Cats; Chloramphenicol; Conjunctivitis; Feeding and Eating Disorders; Female; Humans; Mucous Membrane; Oxytetracycline; Rickettsia Infections; Vitamin B 12

Topics: Anemia; Anemia, Hypochromic; Bone Marrow Cells; Bone Marrow Examination; Child, Preschool; Deficiency Diseases; Dietary Proteins; Egypt; Erythrocytes, Abnormal; Erythropoiesis; Folic Acid; Folic Acid Deficiency; Hemoglobinometry; Humans; Infant; Iron; Iron-Dextran Complex; Kwashiorkor; Nutrition Disorders; Protein Deficiency; Reticulocytes; Vitamin B 12; Vitamin E

Topics: Adult; Age Factors; Aged; Anemia; Anemia, Hypochromic; Anemia, Macrocytic; Blood Proteins; Chronic Disease; Female; Folic Acid; Hematocrit; Hemoglobinometry; Humans; Iron; Male; Middle Aged; Protein Deficiency; Pyridoxine; Serum Albumin; Serum Globulins; Sex Factors; Thiamine; Vitamin B 12; Vitamins

Topics: Anemia; Female; Humans; Malonates; Middle Aged; Spinal Cord Diseases; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Adolescent; Adult; Aged; Agranulocytosis; Anemia; Bone Marrow; Bone Marrow Cells; Cell Division; Cell Nucleus; Diploidy; DNA; Erythrocytes; Erythropoiesis; Female; Hematologic Diseases; Hemorrhage; Humans; Male; Middle Aged; Photometry; Polycythemia; Reticulocytes; Time Factors; Vitamin B 12

Topics: Anemia; Biopsy; Blood Transfusion; Bone Marrow Examination; Female; Humans; Joint Diseases; Middle Aged; Multiple Myeloma; Vitamin B 12

Topics: Anemia; Bone Marrow Cells; Erythropoiesis; Female; Folic Acid; Hematocrit; Humans; Nigeria; Pregnancy; Pregnancy Complications, Hematologic; Time Factors; Vitamin B 12

Topics: Adult; Anemia; Autoanalysis; Blood Cell Count; Blood Proteins; Blood Urea Nitrogen; Body Weight; Chlorides; Fasting; Female; Headache; Hematocrit; Hemoglobins; Humans; Hypokalemia; Hyponatremia; Ketone Bodies; Malabsorption Syndromes; Male; Nausea; Obesity; Time Factors; Uric Acid; Vitamin B 12; Vitamins; Water-Electrolyte Balance

Topics: Adolescent; Adult; Alpha-Globulins; Anemia; Blood Cell Count; Blood Sedimentation; Female; Humans; Infections; Kidney Failure, Chronic; Male; Neoplasms; Protein Binding; Vitamin B 12

Topics: Adolescent; Adult; Anemia; Child; Child, Preschool; Female; Folic Acid; Folic Acid Deficiency; Hemoglobins; Hemosiderin; Hookworm Infections; Humans; India; Infant; Iron; Israel; Male; Mexico; Nutrition Disorders; Nutritional Requirements; Poland; Pregnancy; Pregnancy Complications, Hematologic; Venezuela; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Adult; Aged; Anemia; Anemia, Macrocytic; Anemia, Pernicious; Biopsy; Blood Cell Count; Bone Marrow Examination; Carotenoids; Cholesterol; Diagnosis, Differential; Female; Folic Acid; Folic Acid Deficiency; Gastric Acidity Determination; Hematocrit; Hemoglobinometry; Humans; Hypothyroidism; Iron; Jejunum; Kidney Function Tests; Liver Function Tests; Middle Aged; Myxedema; Thyroid Function Tests; Thyroidectomy; Vitamin B 12

Topics: Anemia; Bone Marrow Examination; Cobalt Isotopes; Diphyllobothriasis; Erythrocyte Count; Folic Acid; Hematocrit; Humans; Injections, Intravenous; Vitamin B 12

Topics: Adult; Aged; Anemia; Anemia, Pernicious; Cobalt Isotopes; Coenzymes; Erythropoiesis; Female; Humans; Kinetics; Male; Middle Aged; Time Factors; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Adrenal Cortex Hormones; Anemia; Female; Humans; Iron; Pregnancy; Pregnancy Complications, Hematologic; Vitamin B 12

Topics: Anemia; Chromatography; Cobalt Isotopes; Feces; Folic Acid; Gastrointestinal Diseases; Hematologic Diseases; Humans; Intestinal Diseases; Leukemia; Myelitis; Radiometry; Stomach Diseases; Tritium; Vitamin B 12

Topics: Adolescent; Adult; Anemia; Anemia, Hypochromic; Anemia, Macrocytic; Bilirubin; Blood Cell Count; Blood Proteins; Child; Child, Preschool; Cholesterol; Diet Therapy; Female; Folic Acid; Folic Acid Deficiency; Health Surveys; Hematocrit; Hemoglobinometry; Humans; Intestinal Diseases, Parasitic; Iron; Male; Pregnancy; Pregnancy Complications, Hematologic; Trinidad and Tobago; Vitamin B 12

Topics: Adolescent; Adult; Anemia; Blood Transfusion; Bone Marrow; Deficiency Diseases; Diet Therapy; Female; Folic Acid; Hematocrit; Humans; Iron; Male; Middle Aged; Renal Dialysis; Uremia; Vitamin B 12

Topics: Anemia; Folic Acid; Folic Acid Deficiency; Humans; Vitamin B 12

Topics: Aged; Anemia; Bilirubin; Blood Cell Count; Cholesterol; Chronic Disease; Humans; Liver Diseases; Liver Extracts; Liver Function Tests; Middle Aged; Nitrogen; Nucleosides; Transaminases; Vitamin B 12; Vitamin B Complex

Topics: Abortion, Spontaneous; Anemia; Animals; Body Weight; Congenital Abnormalities; Diet; Female; Germ-Free Life; Kidney; Liver; Pregnancy; Rats; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Anemia; Cobalt; Erythropoietin; Gastric Juice; Gastrointestinal Diseases; Humans; Iron; Mucoproteins; Vitamin B 12

Topics: Anemia; Blood Proteins; Electrocardiography; Humans; Leukemia; Vitamin B 12

Topics: Anemia; Anemia, Sideroblastic; Blood Transfusion; Diabetes Insipidus; Humans; Infant, Newborn; Intellectual Disability; Male; Pyridoxine; Renal Aminoacidurias; Vitamin B 12

Topics: Adolescent; Adult; Anemia; Anemia, Hypochromic; Blood Sedimentation; Colitis, Ulcerative; Female; Folic Acid; Hemoglobinometry; Humans; Male; Middle Aged; Serum Albumin; Sex; Vitamin B 12

Topics: Alcoholism; Anemia; Bone Marrow; Bone Marrow Cells; Cytoplasm; Diet; Erythrocyte Count; Fatty Liver; Folic Acid; Humans; Male; Vitamin B 12

Topics: Anemia; Animals; Pantothenic Acid; Rats; Vitamin B 12; Vitamin B Deficiency

Topics: Anemia; Blood Volume; Blood Volume Determination; Bone Marrow Examination; Erythrocytes; Erythropoiesis; Female; Folic Acid; Hemoglobinometry; Humans; Iron; Plasma Volume; Pregnancy; Pregnancy Complications, Hematologic; Vitamin B 12

Topics: Anemia; Anemia, Macrocytic; Bone Marrow Examination; Folic Acid; Folic Acid Deficiency; Hemoglobinometry; Humans; Iron; Postgastrectomy Syndromes; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Acetoacetates; Anemia; Animals; Glucose; Proteins; Rats; Vitamin B 12

Topics: Anemia; Animals; Female; Folic Acid; Folic Acid Deficiency; Hemoglobinometry; Horse Diseases; Horses; Iron; Male; Vitamin B 12

Topics: Adolescent; Adult; Aged; Anemia; Child; Cholesterol; Chronic Disease; Coronary Disease; Female; Humans; Lipids; Male; Middle Aged; Phospholipids; Splenectomy; Triglycerides; Vitamin B 12

Topics: Anemia; Anemia, Hemolytic; Anemia, Hypochromic; Anemia, Macrocytic; Anemia, Pernicious; Folic Acid Deficiency; Humans; Injections, Intramuscular; Injections, Intravenous; Iron; Splenectomy; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Anemia; Blood Protein Electrophoresis; Blood Proteins; Chronic Disease; Hepatitis; Humans; Leukemia; Vitamin B 12

Topics: Adolescent; Adult; Africa, Southern; Anemia; Anemia, Hypochromic; Anemia, Macrocytic; Anemia, Sideroblastic; Asia; Australia; Europe; Female; Folic Acid; Gestational Age; Humans; Iron; Israel; Mexico; Pregnancy; Pregnancy Complications, Hematologic; United States; Vitamin B 12

Topics: Adrenal Cortex Hormones; Adult; Aged; Anemia; Chromatography, Thin Layer; Drug Synergism; Female; Glucocorticoids; Humans; Liver Extracts; Male; Middle Aged; Vitamin B 12

Topics: Anemia; Animals; Coenzymes; Dogs; Hydroxocobalamin; Liver; Male; Rabbits; Rats; Vitamin B 12

Topics: Anemia; Animals; Cobalt; Sheep; Sheep Diseases; Vitamin B 12

Topics: Adolescent; Adult; Aged; Anemia; Choline; Female; Folic Acid; Hemochromatosis; Humans; Hydroxybutyrates; Liver Diseases; Male; Middle Aged; Niacinamide; Phosphoric Acids; Pyridoxine; Vitamin B 12

Topics: Aged; Anemia; Ascorbic Acid; Humans; Iron; Male; Scurvy; Vitamin B 12

Topics: Anemia; Female; Folic Acid; Folic Acid Deficiency; Humans; Iron; Pregnancy; Pregnancy Complications, Hematologic; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Adult; Aminosalicylic Acids; Anemia; Anemia, Sideroblastic; Erythropoiesis; Ethionamide; Female; Folic Acid Deficiency; Glucosephosphate Dehydrogenase Deficiency; Humans; In Vitro Techniques; Isoniazid; Prednisolone; Pyrazinamide; Pyridoxine; Streptomycin; Tuberculosis, Pulmonary; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Diagnosis, Differential; Humans; Intestinal Absorption; Intrinsic Factor; Metabolism; Proteinuria; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Anemia; Anemia, Macrocytic; Anemia, Pernicious; Blood; Folic Acid; Folic Acid Deficiency; Hematinics; Humans; Malabsorption Syndromes; Nutrition Disorders; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Blood Cell Count; Blood Chemical Analysis; Bone Marrow Examination; Cobamides; Coenzymes; Drug Therapy; Geriatrics; Hematocrit; Hemoglobinometry; Humans; Metabolism; Vitamin B 12

Topics: Anemia; Anemia, Macrocytic; Anemia, Pernicious; Drug Therapy; Hematinics; Humans; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Anemia; Anemia, Macrocytic; Anemia, Megaloblastic; Bone Marrow Examination; Child; Fluids and Secretions; Folic Acid; Humans; Infant; Metabolism, Inborn Errors; Nucleosides; Orotic Acid; Prognosis; Purine-Pyrimidine Metabolism, Inborn Errors; Pyridoxine; Thyroxine; Uridine; Urine; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Corrinoids; Drug Therapy; Glutamates; Hemoglobins; Humans; Reticulocytes; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Corrinoids; Drug Therapy; Glutamates; Hemoglobins; Humans; Reticulocytes; Vitamin B 12

Topics: Anemia; Anemia, Macrocytic; Anemia, Pernicious; Bone Marrow Examination; Classification; Clinical Laboratory Techniques; Drug Therapy; Folic Acid; Humans; Vitamin B 12

Topics: Anemia; Anemia, Macrocytic; Biological Assay; Bone Marrow Examination; Clinical Enzyme Tests; Erythropoiesis; Folic Acid; Folic Acid Deficiency; Humans; Hydroxybutyrate Dehydrogenase; L-Lactate Dehydrogenase; Lactobacillus; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Antibodies; Bile; Biological Transport; Blood; Cholecystectomy; Cobalt Isotopes; Diagnosis; Drug Therapy; Enterohepatic Circulation; Hematinics; Humans; Intestinal Absorption; Intrinsic Factor; Lactobacillus; Vitamin B 12

Nine patients are described, four men and five women, aged between 14 and 62 years, who presented with symptoms of severe anaemia. Deficiencies of iron and folic acid were subsequently demonstrated in each case. Although malabsorption was not initially suspected, further investigations showed an abnormally high excretion of faecal fat in seven cases. Anaemias which are ;unexplained' or which show a suboptimal response to treatment should be investigated from the viewpoint of intestinal dysfunction. Such anaemias are not a particularly uncommon problem.

Topics: Adolescent; Adult; Anemia; Anemia, Hypochromic; Celiac Disease; Female; Folic Acid; Glucose Tolerance Test; Humans; Iron; Male; Occult Blood; Vitamin B 12

Topics: Alcoholism; Anemia; Anemia, Hypochromic; Blood Chemical Analysis; Blood Volume; Bone Marrow Examination; Erythropoiesis; Folic Acid; Folic Acid Deficiency; Gastric Juice; Hematocrit; Hemochromatosis; Hemolysis; Humans; Iron; Liver; Liver Cirrhosis; Liver Diseases; Melena; Metabolism; Splenomegaly; Vitamin B 12

Topics: Anemia; Anemia, Aplastic; Anemia, Pernicious; Blood Transfusion; Bone Marrow Examination; Clinical Laboratory Techniques; Cobalt; Drug Therapy; Erythrocytes; Humans; Hydroxocobalamin; Prednisone; Pyridoxine; Riboflavin; Testosterone; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Blood Chemical Analysis; Cobalt Isotopes; Diagnosis, Differential; Fluids and Secretions; Hematinics; Humans; Intestinal Absorption; Radiometry; Schilling Test; Statistics as Topic; Urine; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Anemia; Anemia, Hypochromic; Autoantibodies; Autoimmune Diseases; Biological Assay; Biopsy; Cobalt Isotopes; Complement Fixation Tests; Fluorescent Antibody Technique; Folic Acid; Gastric Acidity Determination; Gastritis; Gastritis, Atrophic; Humans; Intestinal Absorption; Pathology; Thyroid Gland; Vitamin B 12

Topics: Anemia; Anemia, Macrocytic; Blood Chemical Analysis; Bronchi; Bronchial Neoplasms; Carcinoma, Squamous Cell; Celiac Disease; Feces; Fluids and Secretions; Folic Acid; Folic Acid Deficiency; Humans; Hypokalemia; Hypoproteinemia; Jejunum; Lipid Metabolism; Malabsorption Syndromes; Pathology; Urine; Vitamin B 12

Topics: Anemia; Anemia, Macrocytic; Cobalt Isotopes; Drug Therapy; Fluids and Secretions; Humans; Hydroxocobalamin; Metabolism; Urine; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Anemia; Anemia, Macrocytic; Bone Marrow Examination; Diet; Drug Therapy; Female; Fetal Death; Folic Acid; Liver; Maternal Mortality; Nigeria; Pathology; Pregnancy; Pregnancy Complications; Pregnancy Complications, Hematologic; Seasons; Statistics as Topic; Vitamin B 12

Topics: Anemia; Anemia, Macrocytic; Avitaminosis; Blood Cell Count; Bone Marrow Examination; Child; FIGLU Test; Folic Acid; Folic Acid Deficiency; Glutamates; Glutamic Acid; Histidine; Humans; Imidazoles; Kwashiorkor; Metabolism; Urine; Urocanic Acid; Vitamin B 12

Topics: Anemia; Anemia, Hypochromic; Biological Transport; Blood; Cobalt Isotopes; Feces; Gastrointestinal Absorption; Hematologic Diseases; Humans; Intestinal Absorption; Iron; Metabolism; Radiometry; Urine; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Delayed-Action Preparations; Drug Therapy; Hematinics; Humans; Hydroxocobalamin; Vitamin B 12

Topics: Anemia; Anemia, Macrocytic; Anemia, Megaloblastic; Drug Therapy; Folic Acid; Hemochromatosis; Humans; Vitamin B 12

Topics: Anemia; Anemia, Macrocytic; Blood Chemical Analysis; Bone Diseases; Calcium; Calcium, Dietary; Celiac Disease; Drug Therapy; Folic Acid; Gastrectomy; Geriatrics; Humans; Iron; Malabsorption Syndromes; Postgastrectomy Syndromes; Postoperative Care; Postoperative Complications; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Carbachol; Cobalt Isotopes; Corrinoids; Fasting; Humans; Injections, Intramuscular; Intestinal Absorption; Pharmacology; Schilling Test; Urine; Vitamin B 12

Topics: Alkylation; Amino Acids; Anemia; Anemia, Pernicious; Biochemical Phenomena; Biochemistry; Chemistry Techniques, Analytical; Chromatography; Enzyme Inhibitors; Enzyme Repression; Escherichia coli; Feedback; Flavin-Adenine Dinucleotide; Folic Acid; Methionine; Methylenetetrahydrofolate Reductase (NADPH2); Mutation; Oxidoreductases; Research; Spectrophotometry; Tetrahydrofolates; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Clinical Laboratory Techniques; Cobalt Isotopes; Fluids and Secretions; Laboratories; Radiometry; Scintillation Counting; Urine; Vitamin B 12

Topics: Anemia; Anemia, Macrocytic; Brazil; Child; Deficiency Diseases; Diet; Diet Therapy; Dietary Proteins; Drug Therapy; Erythrocyte Count; Folic Acid; Glycine max; Hemoglobinometry; Humans; Infant; Milk; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Biopsy; Blood; Bone Marrow Examination; Child; Gastric Juice; Gastric Mucosa; Genetics, Medical; Humans; Intestinal Absorption; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Chromium Isotopes; Drug Therapy; Erythrocytes; Erythropoiesis; Hemoglobinuria; Hemoglobinuria, Paroxysmal; Hemolysis; Humans; Reticulocytes; Vitamin B 12

Topics: Anemia; Anemia, Macrocytic; Anemia, Pernicious; Blood Chemical Analysis; Clinical Laboratory Techniques; Cobalt Isotopes; Gastrectomy; Glutamates; Hematinics; Histamine; Humans; Intestinal Absorption; Intrinsic Factor; Lactobacillus; Pharmacology; Radiometry; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Antibody Formation; Diagnosis; Humans; Intrinsic Factor; Malabsorption Syndromes; Metabolism; Pharmacology; Schilling Test; Vitamin B 12

Topics: Anemia; Anemia, Macrocytic; Anemia, Megaloblastic; Blood Chemical Analysis; Diet; Diet Therapy; Drug Therapy; FIGLU Test; Folic Acid; Folic Acid Deficiency; Geriatrics; Hematinics; Hemochromatosis; Humans; Liver Cirrhosis; Liver Function Tests; Metabolism; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Atrophy; Cobalt Isotopes; Drug Therapy; Gastric Acidity Determination; Gastric Mucosa; Geriatrics; Hematinics; Humans; Intrinsic Factor; Pathology; Prednisolone; Regeneration; Vitamin B 12

Topics: Anemia; Anemia, Macrocytic; Biological Assay; Blood; Diet; Female; FIGLU Test; Folic Acid; Folic Acid Deficiency; Hematocrit; Hemoglobins; Histidine; Humans; Iron; Lactobacillus; Metabolism; Pregnancy; Pregnancy Complications; Pregnancy Complications, Hematologic; Urine; Vitamin B 12; Vitamin B Complex

Topics: Anemia; Anemia, Hypochromic; Blood Cell Count; Blood Proteins; Bone Marrow Cells; Child; Diagnosis; Diet; Diet Therapy; Dietary Proteins; Drug Therapy; FIGLU Test; Folic Acid; Hemoglobinometry; Humans; Infant; Kwashiorkor; Proteins; Uganda; Vitamin B 12

Topics: Alcoholism; Anemia; Anemia, Macrocytic; Ankyrins; Blood Transfusion; Drug Therapy; Folic Acid; Folic Acid Deficiency; Hematinics; Humans; Injections; Spherocytosis, Hereditary; Vitamin B 12

Topics: Ancylostoma; Anemia; Anemia, Hypochromic; Animals; Blood Circulation; Blood Flow Velocity; Cobalt Isotopes; Hemodynamics; Hookworm Infections; Humans; Intestinal Absorption; Isotopes; Liver; Liver Function Tests; Metabolism; Radiometry; Serum Albumin; Serum Albumin, Radio-Iodinated; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Biomedical Research; Drug Therapy; Hematinics; Humans; Intrinsic Factor; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Drug Therapy; Duodenum; Hematinics; Humans; Intestinal Secretions; Intrinsic Factor; Vitamin B 12; Vitamins

Topics: Anemia; Anemia, Macrocytic; Corrinoids; Folic Acid; Folic Acid Deficiency; Humans; Radioisotopes; Thymidine; Vitamin B 12

Topics: Adolescent; Anemia; Ascorbic Acid; Child; Corrinoids; Folic Acid; Geriatrics; Humans; Injections, Intravenous; Liver Diseases; Niacinamide; Syndrome; Vitamin B 12; Vitamin B Complex; Vitamins

Topics: Anemia; Anemia, Hypochromic; Anemia, Macrocytic; Blood; Blood Cell Count; Bone Marrow Examination; Child; Egypt; Hematocrit; Hemoglobins; Humans; Infant; Kwashiorkor; Protein Deficiency; Vitamin B 12; Vitamin E

Topics: Anemia; Anemia, Megaloblastic; Anemia, Pernicious; Blood Chemical Analysis; Hematinics; Humans; Vitamin B 12; Vitamins

Topics: Anemia; Anemia, Hypochromic; Anemia, Macrocytic; Anemia, Megaloblastic; Blood; Drug Therapy; Folic Acid; Hematopoiesis; Humans; Vitamin B 12

Topics: Anemia; Anemia, Macrocytic; Calcium; Calcium, Dietary; Diet; Diet Therapy; Dietary Fats; Drug Therapy; Fats; Humans; Ileum; Intestines; Jejunum; Magnesium; Malabsorption Syndromes; Postoperative Complications; Surgical Procedures, Operative; Vitamin B 12; Vitamin B 12 Deficiency; Vitamins

Topics: Anemia; Anemia, Macrocytic; Animals; Diet; Dietary Proteins; Erythrocytes; Female; Hemoglobins; Humans; Israel; Poultry; Pregnancy; Statistics as Topic; Vitamin B 12

Topics: Altitude; Anemia; Anemia, Hypochromic; Blood Cell Count; Blood Platelets; Body Height; Body Weight; Dextrans; Diet; Folic Acid; Hemoglobinometry; Humans; Japan; Occupations; Periodicity; Reference Values; Reticulocytes; Seasons; Sex; Sports; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Corrinoids; Cortisone; Dogs; Duodenum; Hematinics; Hyperparathyroidism; Intrinsic Factor; Pathology; Research; Stomach Ulcer; Thyroidectomy; Vitamin B 12

Topics: Anemia; Hepatitis; Humans; Leukemia; Liver Cirrhosis; Vitamin B 12

Topics: Anemia; Female; Folic Acid; Humans; Iron; Liver Extracts; Pregnancy; Vitamin B 12

Topics: Anemia; Blood; Female; Hemoglobins; Humans; In Vitro Techniques; Iron; Pregnancy; Pregnancy Complications, Hematologic; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Blood Chemical Analysis; Hematinics; Humans; Hydroxocobalamin; Urine; Vitamin B 12

Topics: Agammaglobulinemia; Anemia; Anemia, Pernicious; Autoimmune Diseases; Blood Protein Electrophoresis; Cobalt Isotopes; Corrinoids; Genetics, Medical; Hematinics; Humans; Myxedema; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Autoantibodies; Autoimmunity; Biopsy; Blood Chemical Analysis; Fluorescent Antibody Technique; Gastric Acidity Determination; Gastric Mucosa; Gastritis; Humans; Iron; Parietal Cells, Gastric; Pathology; Vitamin B 12

Topics: Alkaline Phosphatase; Anemia; Anemia, Hypochromic; Blood; Cobalt Isotopes; Erythropoiesis; Folic Acid; Folic Acid Deficiency; Histidine; Humans; Iron; Primary Myelofibrosis; Tritium; Vitamin B 12; Vitamin B Deficiency

The urinary excretion of injected cyanocobalamin was studied in 30 previously untreated vitamin B(12)-deficient patients by measuring the urinary radioactivity after repeated injections of (58)Co vitamin B(12). The dose range used was 54 to 30,000 mug., each patient receiving the same dose at each injection. The results show that there is no constant trend to the excretion of greater or smaller proportions of the amount injected. It is also shown that there is a wide variation in the amounts excreted by each individual and between individual patients and that the capacity of the tissues to retain injected cyanocobalamin is very great, the amounts retained often being greatly in excess of the normal body stores. The excretion of radioactivity after parenteral infections of (58)Co vitamin B(12) was usually complete within 24 hours but exceptions to this were seen. The significance and value of the results is discussed.

Topics: Anemia; Anemia, Macrocytic; Anemia, Pernicious; Cobalt Isotopes; Humans; Injections, Intravenous; Urine; Vitamin B 12

Topics: Anemia; Anemia, Macrocytic; Anemia, Megaloblastic; Female; Folic Acid; Humans; Pregnancy; Pregnancy Complications; Pregnancy Complications, Hematologic; Vitamin B 12

Topics: Adolescent; Anemia; Anemia, Macrocytic; Blood Sedimentation; Bone Marrow Examination; Erythrocyte Count; Hemoglobinometry; Humans; Liver; Liver Extracts; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Anemia; Anemia, Macrocytic; Anticonvulsants; Biological Assay; Blood Chemical Analysis; Enterococcus faecalis; Epilepsy; Folic Acid; Folic Acid Antagonists; Humans; Lactobacillus; Phenobarbital; Phenytoin; Primidone; Toxicology; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Bone Marrow Examination; Cobalt Isotopes; Corrinoids; Erythrocytes; Hematinics; Humans; Vitamin B 12

Topics: Adolescent; Alkalies; Anemia; Anemia, Hypochromic; Anemia, Pernicious; Blood Chemical Analysis; Erythrocytes; Gastrectomy; Geriatrics; Hematologic Diseases; Humans; Lactobacillus; Leukemia; Leukemia, Lymphoid; Leukemia, Myeloid; Polycythemia Vera; Vitamin B 12; Vitamins

Topics: Anemia; Anemia, Macrocytic; Blood Chemical Analysis; Bone Marrow Examination; Erythropoiesis; Female; Folic Acid; Humans; India; Pregnancy; Vitamin B 12

Topics: Adolescent; Anemia; Anemia, Hypochromic; Blood; Esophagoplasty; Esophagus; Humans; Iron; Jejunum; Surgical Procedures, Operative; Urine; Vitamin B 12; Xylose

Topics: Absorption; Anemia; Anemia, Macrocytic; Animals; Celiac Disease; Cobalt Isotopes; Gastric Juice; Haplorhini; Ileum; India; Kwashiorkor; Macaca mulatta; Protein Deficiency; Research; Sprue, Tropical; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Corrinoids; Hematinics; Humans; Myocardial Infarction; Polycythemia; Polycythemia Vera; Toxicology; Vitamin B 12

Topics: Anemia; Anemia, Hemolytic; Anemia, Hypochromic; Anemia, Pernicious; Blood Coagulation; Blood Proteins; Chloramphenicol; Epidemiology; Epoetin Alfa; Erythropoietin; Haptoglobins; Hematologic Diseases; Hematology; Hemochromatosis; Humans; Iron-Dextran Complex; Leukemia; Polycythemia; Thromboplastin; Vitamin B 12

Topics: Absorption; Agricultural Workers' Diseases; Anemia; Anemia, Hypochromic; Biopsy; Blood Cell Count; Blood Chemical Analysis; Bone Marrow; Digestion; Fatty Acids; Feces; Folic Acid; Hemoglobins; Hookworm Infections; Humans; Intestinal Absorption; Intestines; Jejunum; Urine; Vitamin B 12; Xylose

Topics: Adenosine Triphosphate; Adrenocorticotropic Hormone; Aminocaproates; Aminocaproic Acid; Anabolic Agents; Anemia; Anemia, Hemolytic; Anemia, Hypochromic; Anemia, Macrocytic; Anemia, Pernicious; Blood Transfusion; Bone Marrow Transplantation; Hematologic Diseases; Hematology; Hemophilia A; Humans; Iron; Leukemia; Methandrostenolone; Methyltestosterone; Nandrolone; Purpura; Purpura, Thrombocytopenic; Steroids; Vitamin B 12

Topics: Anemia; Anemia, Macrocytic; Ascorbic Acid; Blood Cell Count; Bone Marrow Examination; Erythropoiesis; Folic Acid; Geriatrics; Glutamates; Hematocrit; Hemoglobinometry; Humans; Iron; Liver Diseases; Liver Extracts; Phosphatidylethanolamines; Pyridoxine; Reticulocytes; Sulfobromophthalein; Urine; Vitamin B 12

Topics: Alcoholism; Anemia; Anemia, Macrocytic; Anorexia Nervosa; Ascorbic Acid; Avitaminosis; Celiac Disease; Deficiency Diseases; Diet; Diet Therapy; Female; Folic Acid; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Pregnancy; Pregnancy Complications; Sprue, Tropical; United Kingdom; Vitamin A; Vitamin B 12; Vitamin B Complex; Vitamin D; Vitamin K; Vitamins; Vomiting

Topics: Anemia; Anemia, Hypochromic; Anemia, Macrocytic; Anemia, Pernicious; Female; Folic Acid; Humans; Iron; Leukocytosis; Pelger-Huet Anomaly; Polycythemia Vera; Pregnancy; Pregnancy Complications; Pregnancy Complications, Hematologic; Thalassemia; Vitamin B 12

Topics: Achlorhydria; Anemia; Anemia, Hypochromic; Anemia, Iron-Deficiency; Autoantibodies; Autoimmune Diseases; Autoimmunity; Blood Chemical Analysis; Cobalt Isotopes; Fluorescent Antibody Technique; Humans; Schilling Test; Stomach; Urine; Vitamin B 12

Topics: Anemia; Anemia, Macrocytic; Corrinoids; Gastrectomy; Hematinics; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Biomedical Research; Corrinoids; Folic Acid; Hematinics; Humans; Injections, Intramuscular; Intrinsic Factor; Liver Extracts; Tablets; Vitamin B 12; Vitamin B Complex

Topics: Achlorhydria; Anemia; Ascorbic Acid; Blood Transfusion; Folic Acid; Geriatrics; Humans; Scurvy; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Anemia; Chromium Isotopes; Diagnosis, Differential; Erythrocytes; Hematinics; Humans; Iron Isotopes; Phosphorus Isotopes; Radioisotopes; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Corrinoids; Folic Acid; Hematinics; Humans; Hydrochloric Acid; Hydroxocobalamin; Liver Extracts; Perception; Stomach; Tissue Extracts; Vitamin B 12

Topics: Anemia; Blood Cell Count; Diagnosis; Fractures, Spontaneous; Hematology; Hematopoietic System; Hepatomegaly; Iron; Liver Diseases; Neoplasms; Neurology; Osteopetrosis; Pathology; Radiography; Splenomegaly; Vitamin B 12

Topics: Anemia; Anemia, Hypochromic; Anemia, Sideroblastic; Dithiazanine; Erythrocyte Count; Genetic Diseases, X-Linked; Humans; Iodides; Iron; Trichuriasis; Vitamin B 12

Topics: Adolescent; Anemia; Anemia, Pernicious; Blood Cell Count; Blood Coagulation; Bone Marrow; Corrinoids; Folic Acid; Hematinics; Humans; Pathology; Vitamin B 12

Topics: Anemia; Anemia, Hemolytic; Anemia, Macrocytic; Anemia, Pernicious; Anticonvulsants; Blood; Celiac Disease; Clinical Laboratory Techniques; Epilepsy; Female; FIGLU Test; Folic Acid; Folic Acid Deficiency; Formiminoglutamic Acid; Glutamates; Humans; Lymphoma; Lymphoma, Non-Hodgkin; Pregnancy; Pregnancy Complications; Pregnancy Complications, Hematologic; Urine; Vitamin B 12; Vitamin B Deficiency

Topics: Anemia; Anemia, Aplastic; Ascorbic Acid; Bone Marrow; Bone Marrow Transplantation; Humans; Pyridoxine; Testosterone; Twins; Vitamin B 12

Topics: Anemia; Blood; Corrinoids; Diagnosis; Erythrocytes; Hematinics; Iron; Physiology; Vitamin B 12

Topics: Alcoholic Intoxication; Alcoholism; Anemia; Aspartic Acid; Asthenia; Humans; Liver Cirrhosis; Liver Diseases; Liver Extracts; Magnesium; Nutrition Disorders; Postoperative Care; Potassium; Vitamin B 12; Yeast, Dried

Topics: Anemia; Anemia, Pernicious; Animals; Cestode Infections; Diphyllobothriasis; Diphyllobothrium; Epidemiology; Finland; Fishes; Humans; Vitamin B 12

Topics: Anemia; Anemia, Hypochromic; Anemia, Macrocytic; Anemia, Pernicious; Humans; Hypothyroidism; Iron; Myxedema; Thyroid Hormones; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Blood Chemical Analysis; Creatine; Creatinine; Humans; Hydroxocobalamin; Injections; Injections, Intramuscular; Vitamin B 12; Vitamin B 12 Deficiency; Vitamin B Complex

Topics: Achlorhydria; Anemia; Anemia, Hypochromic; Anemia, Pernicious; Atrophy; Blood Chemical Analysis; Cobalt Isotopes; Deglutition Disorders; Gastric Acidity Determination; Hemoglobinometry; Histamine; Humans; Iron; Middle Aged; Plummer-Vinson Syndrome; Schilling Test; Stomach; Urine; Vitamin B 12

Topics: Aminosalicylic Acid; Aminosalicylic Acids; Anemia; Anemia, Macrocytic; Cobalt Isotopes; Corrinoids; Humans; Schilling Test; Toxicology; Urine; Vitamin B 12; Vitamin B 12 Deficiency

There is a significant fall in the serum folic acid level during pregnancy, reaching its lowest level at term. This is most pronounced in twin pregnancies. A similar but less spectacular fall occurs in the vitamin B(12) concentration. In megaloblastic anaemia both folic acid and vitamin B(12) levels are lower than in other pregnant women. The degree of megaloblastic change in the bone marrow, as measured by the type and number of megaloblasts, is reflected in the vitamin levels, cases with florid megaloblastosis showing the most marked depression of vitamin B(12) and folic acid activity. Although there is a significant difference in the mean folic acid levels between megaloblastic and normoblastic pregnant women, a considerable overlap exists between individual values in the two groups. When the labile folic-acid factor is determined separately the test becomes much more specific. In the present series, all cases of megaloblastic anaemia yielded labile-factor levels below 1.0 mmug. per ml., while a similar value was encountered in only one of 35 normal pregnancies. In five women with megaloblastic anaemia the vitamin B(12) concentration was less than 100 mumug. per ml. but rose to normal levels on folic acid therapy alone.

Topics: Anemia; Anemia, Macrocytic; Anemia, Megaloblastic; Biological Assay; Blood; Bone Marrow; Bone Marrow Examination; Classification; Euglena; Female; Folic Acid; Humans; Lactobacillus; Pregnancy; Pregnancy Complications; Pregnancy Complications, Hematologic; Twins; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Anemia; Anemia, Pernicious; Ascorbic Acid; Clinical Enzyme Tests; Dehydroascorbic Acid; Erythrocytes; Hemolysis; Humans; Oxidoreductases; Vitamin B 12

Topics: Adolescent; Anemia; Anemia, Aplastic; Blood Transfusion; Congenital Abnormalities; Corrinoids; Dextrocardia; Fanconi Anemia; Humans; Iron; Radiography, Thoracic; Vitamin B 12

Topics: Absorption; Anemia; Anemia, Pernicious; Biomedical Research; Cobalt Isotopes; Electrophoresis; Gastrectomy; Gastric Juice; Humans; Intrinsic Factor; Radioisotopes; Radionuclide Imaging; Stomach; Urine; Vitamin B 12; Zollinger-Ellison Syndrome

Topics: Achlorhydria; Anemia; Anemia, Pernicious; Animals; Cobalt Isotopes; Electrophoresis; Gastrectomy; Gastric Juice; Gastric Mucosa; Guinea Pigs; Histamine; In Vitro Techniques; Intestinal Mucosa; Intrinsic Factor; Pathology; Peptic Ulcer; Rats; Research; Saliva; Stomach Neoplasms; Urine; Vagus Nerve; Vitamin B 12

Topics: Anemia; Anemia, Hemolytic; Blood Protein Disorders; Brain Neoplasms; Chlormerodrin; Chromium Isotopes; Clinical Laboratory Techniques; Cobalt Isotopes; Diuretics; Erythrocytes; Heart Diseases; Hypoproteinemia; Iodine Isotopes; Kidney Diseases; Liver Diseases; Lung Diseases; Neoplasms; Obesity; Organomercury Compounds; Polycythemia; Protein Deficiency; Pulmonary Embolism; Radiation Protection; Radioisotopes; Radiometry; Radionuclide Imaging; Schilling Test; Spleen; Thinness; Thyroid Diseases; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Blood Transfusion; Deficiency Diseases; Deglutition Disorders; Digoxin; Diuretics; Esophagoscopy; Geriatrics; Hematinics; Humans; Iron; Plummer-Vinson Syndrome; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Anemia; Anemia, Pernicious; Cell Division; Cobalt Isotopes; Corrinoids; Culture Media; DNA; Glucose; Leukocytes; Lymphocytes; Salts; Schilling Test; Tissue Culture Techniques; Urine; Vitamin B 12

Topics: Alcoholism; Anemia; Anemia, Hypochromic; Avitaminosis; Cholestyramine Resin; Common Bile Duct; Diet; Diet Therapy; Diuretics; Folic Acid; Folic Acid Deficiency; Gastrointestinal Hemorrhage; Humans; Hydrochlorothiazide; Ion Exchange Resins; Jaundice; Liver Cirrhosis; Liver Cirrhosis, Biliary; Postoperative Complications; Prothrombin Time; Vitamin B 12; Vitamin B Complex; Vitamin K

Topics: Anemia; Anemia, Hypochromic; Arthritis; Arthritis, Rheumatoid; Cobalt; Corrinoids; Iron; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Drug Therapy; Hematinics; Humans; Hydroxocobalamin; Vitamin B 12

Topics: Aging; Anemia; Anemia, Hypochromic; Anemia, Macrocytic; Avitaminosis; Biomedical Research; Calcium; Enzymes; Erythrocytes; Erythrocytes, Abnormal; Folic Acid; Geriatrics; Spherocytes; Vitamin B 12; Vitamin B Complex; Vitamin D; Vitamins

Topics: Anemia; Anemia, Macrocytic; Anemia, Megaloblastic; Celiac Disease; Classification; Folic Acid; Folic Acid Deficiency; Humans; Japan; Metabolism; Physiology; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Anemia; Blood; Blood Cells; Blood Transfusion; Bone Marrow; Cobalt Isotopes; Feces; Hemolysis; Hemorrhage; Kidney; Kinetics; Liver; Metabolism; Phenylhydrazines; Rats; Research; Urine; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Bone Marrow; Cell Division; Colchicine; Drug Therapy; Erythrocyte Count; Erythrocytes; Erythropoiesis; Hemoglobins; Hemolysis; Humans; In Vitro Techniques; Iron; Iron Isotopes; Megaloblasts; Research; Reticulocytes; Spectrophotometry; Tissue Culture Techniques; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Bone Marrow; Drug Therapy; Erythrocyte Count; Erythrocytes; Erythropoiesis; Hemoglobins; Humans; In Vitro Techniques; Iron; Iron Isotopes; Megaloblasts; Phenanthrolines; Research; Reticulocytes; Spectrophotometry; Tissue Culture Techniques; Vitamin B 12

Topics: Anemia; Blood Chemical Analysis; Epoetin Alfa; Erythropoietin; Hematinics; Intestine, Small; Intestines; Postgastrectomy Syndromes; Surgical Procedures, Operative; Urine; Vitamin B 12

Topics: Absorption; Anemia; Anemia, Pernicious; Celiac Disease; Cobalt Isotopes; Cobamides; Coenzymes; Drug Therapy; Erythrocytes; Humans; Intestine, Small; Intestines; Intrinsic Factor; Leukemia, Erythroblastic, Acute; Leukemia, Myeloid; Liver; Male; Metabolism; Reticulocytes; Schilling Test; Urine; Vitamin B 12

Topics: Anemia; Anemia, Macrocytic; Avitaminosis; Biological Assay; Biopsy; Blood; Bone Marrow Examination; Cerebrospinal Fluid; Clinical Laboratory Techniques; Diet; Folic Acid; Folic Acid Deficiency; Jejunum; Lactobacillus; Metabolism; Pathology; Vitamin B 12; Vitamin B Deficiency

Topics: Anemia; Anemia, Macrocytic; Anemia, Pernicious; Avitaminosis; Clinical Laboratory Techniques; Female; FIGLU Test; Folic Acid; Folic Acid Deficiency; Formiminoglutamic Acid; Geriatrics; Glutamates; Humans; Maternal-Fetal Exchange; Metabolism; Pregnancy; Primary Myelofibrosis; Urine; Vitamin B 12; Vitamin B Deficiency

Topics: Anemia; Anemia, Hypochromic; Anemia, Macrocytic; Carbachol; Celiac Disease; Cobalt Isotopes; Colonic Neoplasms; Duodenal Ulcer; Folic Acid; Folic Acid Deficiency; Gastric Acidity Determination; Gastric Juice; Histamine; Humans; Insulin; Intrinsic Factor; Male; Pharmacology; Physiology; Sprue, Tropical; Vitamin B 12

Topics: Anemia; Anemia, Hypochromic; Anemia, Pernicious; Anxiety; Anxiety Disorders; Arthritis; Arthritis, Rheumatoid; Bone Marrow Examination; Depression; Depressive Disorder; Drug Therapy; Humans; Neurotic Disorders; Paranoid Disorders; Vitamin B 12; Vitamin B 12 Deficiency; Xylose

Topics: Alkaline Phosphatase; Anemia; Anemia, Hypochromic; Anemia, Pernicious; Depressive Disorder; Hematinics; Humans; Intestines; Liver; Metabolism; Vitamin B 12

Topics: Adolescent; Anemia; Anemia, Hypochromic; Anemia, Macrocytic; Breast Neoplasms; Bronchopneumonia; Child; Deficiency Diseases; Female; Folic Acid; Gastroenterology; Geriatrics; Hemorrhage; Humans; Liver Diseases; Liver Extracts; Multiple Myeloma; Nucleosides; Postpartum Hemorrhage; Postpartum Period; Rheumatic Fever; Sepsis; Toxicology; Virus Diseases; Vitamin B 12; Vitamin B Complex

Topics: Anemia; Anemia, Pernicious; Blood Chemical Analysis; Blood Proteins; Corrinoids; Humans; Hydroxocobalamin; Injections, Intramuscular; Metabolism; Urine; Vitamin B 12

Topics: Anemia; Anemia, Hypochromic; Animals; Coenzymes; Dogs; Iron; Rabbits; Rats; Research; Vitamin B 12

Topics: Anemia; Anemia, Macrocytic; Bone and Bones; Calcium; Folic Acid; Folic Acid Deficiency; Gastrectomy; Humans; Statistics as Topic; Vitamin B 12

Topics: Absorption; Anemia; Anemia, Hypochromic; Anemia, Macrocytic; Anemia, Pernicious; Blood Chemical Analysis; Bone Marrow Examination; Cobalt Isotopes; Folic Acid; Folic Acid Deficiency; Gastrectomy; Humans; Postgastrectomy Syndromes; Vitamin B 12

Topics: Anemia; Anemia, Hypochromic; Anemia, Macrocytic; Blood Proteins; Copper; Drug Therapy; Female; Hematocrit; Hemoglobinometry; Humans; Iron; Postpartum Hemorrhage; Postpartum Period; Pregnancy; Pregnancy Complications; Pregnancy Complications, Hematologic; Shock, Hemorrhagic; Vitamin B 12

Topics: Anemia; Anemia, Macrocytic; Anemia, Pernicious; Folic Acid; Humans; Liver Extracts; Vitamin B 12

Topics: Anemia; Anemia, Hypochromic; Female; Folic Acid; Hematinics; Humans; Iron; Pregnancy; Pregnancy Complications, Hematologic; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Autoantibodies; Hematologic Diseases; Humans; Intrinsic Factor; Pathology; Stomach; Thyroid Gland; Thyroiditis; Thyroiditis, Autoimmune; Vitamin B 12

Topics: Absorption; Anemia; Anemia, Macrocytic; Animals; Bacteria; Cobalt Isotopes; Dietary Fats; Dogs; Feces; Hematinics; Jejunum; Metabolism; Pathology; Research; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Cobalt Isotopes; Electrophoresis; Gastric Juice; Humans; Intrinsic Factor; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Digestion; Duodenal Ulcer; Electrophoresis; Gastric Juice; Heating; Humans; Intrinsic Factor; Vitamin B 12

Topics: Anemia; Anemia, Aplastic; Animals; Blood Cell Count; Blood Proteins; Bone Marrow; Cholesterol; Folic Acid; Haplorhini; Hemoglobins; Humans; Metabolism; Papio; Proteins; Research; Riboflavin Deficiency; Tryptophan; Urine; Vitamin B 12; Xanthurenates

Topics: Anemia; Anemia, Pernicious; Brain Diseases; Cyanides; Delirium; Electroencephalography; Humans; Injections, Intramuscular; Lung Abscess; Male; Metabolism; Poisoning; Staphylococcal Infections; Toxicology; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Erythrocyte Count; Geriatrics; Humans; Leukemia; Leukemia, Lymphoid; Leukopenia; Neoplasms; Reticulocytes; Vitamin B 12

Topics: Anemia; Anemia, Macrocytic; Heart Diseases; Hematinics; Humans; Iron; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Blood Cell Count; Cardiovascular Diseases; Causality; Corrinoids; Drug Therapy; Geriatrics; Humans; Prothrombin Time; Reticulocytes; Thrombosis; Toxicology; Vitamin B 12

Topics: Anemia; Anemia, Aplastic; Ascorbic Acid; Benzene; Corrinoids; Diagnosis; Humans; Occupational Diseases; Pancytopenia; Pyridoxine; Toxicology; Vitamin B 12

Topics: Anemia; Anemia, Macrocytic; Anticonvulsants; Celiac Disease; Female; FIGLU Test; Folic Acid; Folic Acid Antagonists; Folic Acid Deficiency; Formiminoglutamic Acid; Histidine; Humans; Intestinal Diseases; Intestine, Small; Intestines; Liver Diseases; Metabolic Diseases; Neoplasms; Postoperative Complications; Pregnancy; Sprue, Tropical; Vitamin B 12

Topics: Anemia; Anemia, Macrocytic; Anemia, Megaloblastic; Brain Diseases; Cysticercosis; Drug Therapy; Epilepsy; Folic Acid; Humans; Iatrogenic Disease; Phenobarbital; Phenytoin; Primidone; Spinal Cord; Toxicology; Vitamin B 12

Topics: Anemia; Anemia, Macrocytic; Anemia, Megaloblastic; Blood Platelet Disorders; Drug Therapy; Epilepsy; Female; Folic Acid; Hemorrhage; Humans; Phenobarbital; Pregnancy; Pregnancy Complications; Pregnancy Complications, Hematologic; Primidone; Thrombocytopenia; Toxicology; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Blood Volume Determination; Erythropoiesis; Hematocrit; Hemoglobins; Humans; Iron; Iron Isotopes; Kinetics; Pharmacology; Reticulocytes; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Cobalt Isotopes; Corrinoids; Fluids and Secretions; Humans; Intestinal Absorption; Schilling Test; Urine; Vitamin B 12; Vitamins

Topics: Anemia; Anemia, Macrocytic; Antineoplastic Agents; Blood Chemical Analysis; Child; Folic Acid; Humans; Hydroxyurea; Toxicology; Urea; Vitamin B 12

Topics: Anemia; Animals; Dairy Products; Goats; Humans; Infant; Infant Nutrition Disorders; Milk; Toxicology; Vitamin B 12

Topics: Anemia; Anemia, Macrocytic; Biopsy; Blood Chemical Analysis; Bone Marrow Examination; Erythropoiesis; Female; FIGLU Test; Folic Acid; Folic Acid Deficiency; Glutamic Acid; Hemoglobins; Histidine; Lactobacillus; Pregnancy; Pregnancy Complications; Pregnancy Complications, Hematologic; Urine; Vitamin B 12

Topics: Anemia; Anemia, Hypochromic; Anemia, Iron-Deficiency; Anemia, Macrocytic; Blood Platelets; Bone Marrow Cells; Drug Therapy; Epoetin Alfa; Erythropoietin; FIGLU Test; Folic Acid; Folic Acid Deficiency; Glutamates; Hemoglobins; Humans; Infant; Infusions, Parenteral; Injections, Intravenous; Iron; Iron-Dextran Complex; Megakaryocytes; Reticulocytes; Thrombocytopenia; Thrombocytosis; Vitamin B 12

Topics: Anemia; Anemia, Macrocytic; Biological Assay; Blood Chemical Analysis; Bone Marrow Examination; Celiac Disease; Cobalt Isotopes; Euglena; Feces; Fluids and Secretions; Folic Acid; Folic Acid Deficiency; Humans; Intestinal Absorption; Lactobacillus; Singapore; Sprue, Tropical; Statistics as Topic; Urine; Vitamin B 12

Topics: Anemia; Anemia, Macrocytic; Anemia, Pernicious; Black People; Blood Chemical Analysis; Bone Marrow; Deficiency Diseases; Drug Therapy; Folic Acid; Folic Acid Deficiency; Gastric Juice; Gastric Mucosa; Glutamates; Hematopoiesis; Humans; Hydrochloric Acid; Intrinsic Factor; Pathology; Pharmacology; Urine; Vitamin B 12

Topics: Adolescent; Anemia; Biomedical Research; Child; Corrinoids; Drug Therapy; Hematinics; Humans; Infant; Tissue Extracts; Trace Elements; Vitamin B 12; Vitamin B Complex

Topics: Anemia; Anemia, Macrocytic; Anemia, Megaloblastic; Celiac Disease; Diverticulum; Drug Therapy; Geriatrics; Humans; Intestinal Diseases; Intestine, Small; Intestines; Pain; Steatorrhea; Tetracycline; Toxicology; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Blood; Hepatitis; Humans; Leukemia; Leukemia, Myelogenous, Chronic, BCR-ABL Positive; Leukemia, Myeloid; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Bone Marrow Cells; Diagnosis, Differential; Gastric Acid; Gastric Acidity Determination; Humans; Intrinsic Factor; Schilling Test; Vitamin B 12

Topics: Anemia; Anemia, Macrocytic; Anemia, Megaloblastic; Folic Acid; Folic Acid Deficiency; Humans; Vitamin B 12; Vitamin B 12 Deficiency; Yeast, Dried

Topics: Anemia; Anemia, Macrocytic; Anti-Bacterial Agents; Celiac Disease; Diet; Drug Therapy; Folic Acid; Hematinics; Humans; Intestinal Absorption; Jejunum; Metabolism; Sprue, Tropical; Tetracycline; Vitamin B 12

Topics: Achlorhydria; Anemia; Anemia, Pernicious; Blood; Carbachol; Gastric Juice; Gastritis; Gastritis, Atrophic; Geriatrics; Histamine; Humans; Hydrochloric Acid; Intrinsic Factor; Pathology; Pharmacology; Vitamin B 12

Topics: Anemia; Blood Chemical Analysis; Clinical Laboratory Techniques; Cobalt Isotopes; Corrinoids; Humans; Intestinal Absorption; Kidney Function Tests; Nutritional Physiological Phenomena; Nutritional Sciences; Urine; Vitamin B 12

Topics: Anemia; Anemia, Macrocytic; Anemia, Pernicious; Blood Cell Count; Blood Protein Electrophoresis; Calcium; Drug Therapy; Geriatrics; Humans; Immunoelectrophoresis; Iron; Multiple Myeloma; Osteoporosis; Plasmacytoma; Pneumonia; Vitamin B 12; Vitamin B 12 Deficiency; Waldenstrom Macroglobulinemia

Topics: Anemia; Anemia, Pernicious; Biological Assay; Blood Chemical Analysis; Delayed-Action Preparations; Erythrocyte Count; Geriatrics; Hemoglobinometry; Humans; Injections, Intramuscular; Middle Aged; Reticulocytes; Tannins; Vitamin B 12; Vitamin B 12 Deficiency; Vitamins

Topics: Anemia; Anemia, Pernicious; Autoradiography; Bone Marrow Examination; Cytidine; DNA; Erythrocytes; Folic Acid; Hematocrit; Humans; Iron; Nucleosides; Pyrimidines; RNA; Thymidine; Tritium; Uridine; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Autoradiography; gamma-Globulins; Hematinics; Intrinsic Factor; Metabolism; Rats; Research; Stomach; Vitamin B 12

Topics: Allergy and Immunology; Anemia; Anemia, Pernicious; Autoantibodies; Autoimmunity; Blood Group Antigens; Child; Humans; Infant; Intestinal Absorption; Intrinsic Factor; Metabolism; Vitamin B 12

Topics: Anemia; Anemia, Macrocytic; Carbon; Folic Acid; Humans; Metabolism; Methionine; Nucleosides; Tetrahydrofolates; Vitamin B 12

Topics: Anemia; Anemia, Macrocytic; Anemia, Megaloblastic; Anemia, Pernicious; Ascorbic Acid; Folic Acid; Humans; Metabolism; Vitamin B 12

Topics: Anemia; Anemia, Macrocytic; Anemia, Megaloblastic; Drug Therapy; Humans; Polycythemia Vera; Vitamin B 12

Topics: Anemia; Anemia, Macrocytic; Anemia, Megaloblastic; Blood; Blood Cell Count; Geriatrics; Glutamates; Iron; Neutrophils; Pyrimethamine; Toxicology; Urine; Vitamin B 12; Vitamin B Complex

Topics: Anemia; Anemia, Pernicious; Bone Marrow Cells; Corrinoids; Drug Therapy; Granulocyte Precursor Cells; Humans; Leukocytes; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Clinical Laboratory Techniques; Geriatrics; Heart Failure; Humans; Vitamin B 12

Topics: Anemia; Anemia, Macrocytic; Animals; Cobalt Isotopes; Digestive System Surgical Procedures; Dogs; Gastrectomy; Hematinics; Humans; Hydrochloric Acid; Intestinal Absorption; Pylorus; Research; Schilling Test; Surgical Procedures, Operative; Urine; Vagotomy; Vitamin B 12; Vitamins

Topics: Anemia; Anemia, Hypochromic; Anemia, Pernicious; Biological Assay; Blood Chemical Analysis; Chromatography; Erythrocytes; Folic Acid; Folic Acid Deficiency; Hematologic Diseases; Humans; Lactobacillus; Metabolism; Methotrexate; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Central Nervous System Diseases; Clinical Laboratory Techniques; Cobalt Isotopes; Humans; Neurologic Manifestations; Postgastrectomy Syndromes; Schilling Test; Spinal Cord; Urine; Vitamin B 12

Topics: Aged; Anemia; Anemia, Pernicious; Drug Therapy; Geriatrics; Humans; Intrinsic Factor; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Cobalt Isotopes; Humans; Malabsorption Syndromes; Schilling Test; Urine; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Drug Therapy; Humans; Minnesota; Neurologic Manifestations; Vitamin B 12

Topics: Adrenal Cortex Hormones; Anemia; Biomedical Research; Corrinoids; Humans; Liver Extracts; Nandrolone; Thinness; Vitamin B 12; Vitamin B Complex

Topics: Anemia; Crohn Disease; Enteritis; Humans; Intestine, Small; Intestines; Malabsorption Syndromes; Surgical Procedures, Operative; Vitamin B 12

Topics: Anemia; Anemia, Macrocytic; Anemia, Megaloblastic; Drug Therapy; Gastrectomy; Humans; Intrinsic Factor; Vitamin B 12

Topics: Anemia; Anemia, Hemolytic; Anemia, Pernicious; Blood; Bone Marrow; Cobalt Isotopes; Erythrocytes; Erythropoiesis; Hemoglobinuria; Hemoglobinuria, Paroxysmal; Iron Isotopes; Metabolism; Radiation Injuries; Radiation Injuries, Experimental; Radiometry; Rats; Reticulocytes; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Anemia; Anemia, Macrocytic; Anemia, Sideroblastic; Ascorbic Acid; Child; Folic Acid; Humans; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Cobalt Isotopes; Corrinoids; Hematinics; Humans; Radioisotopes; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Atrophy; Bodily Secretions; Cathepsins; Cobalt Isotopes; Gastric Juice; Gastric Mucosa; Gastritis; Gastritis, Atrophic; Histamine Release; Humans; Pepsin A; Urine; Vitamin B 12

Topics: Anemia; Anemia, Hypochromic; Anemia, Iron-Deficiency; Breast Feeding; Female; Folic Acid; Humans; Postpartum Period; Pregnancy; Puerperal Disorders; Vitamin B 12

Topics: Adolescent; Anemia; Blood Proteins; Esophagus; Fats; Feces; Gastrostomy; Humans; Intestinal Absorption; Iron; Iron Isotopes; Jejunum; Male; Postoperative Complications; Radiography; Schilling Test; Sorbitol; Vitamin B 12; Xylose

Topics: Anemia; Anemia, Macrocytic; Anemia, Megaloblastic; Folic Acid; Hematinics; Humans; Incidence; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Cell Nucleus; Female; Humans; Vaginal Smears; Vitamin B 12; Vitamin B Complex

The importance of deficiency of the folic acid group of compounds (folates) in the pathogenesis of nutritional anaemias is receiving increasing recognition. There is evidence that the megaloblastic anaemias, due to either vitamin B(12) or folate deficiency, may be the cause of widespread morbidity in malnourished populations. It was therefore considered timely to review certain aspects of the role of folates in megaloblastic anaemia, with special reference to the dietary intake in relation to human requirements, and the recognition of folate deficiency in man.

Topics: Anemia; Anemia, Macrocytic; Anemia, Megaloblastic; Folic Acid; Folic Acid Deficiency; Humans; Male; Vitamin A Deficiency; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Anemia; Anemia, Pernicious; Hematinics; Humans; Vitamin B 12; Vitamins

Topics: Anemia; Anemia, Macrocytic; Biotin; Humans; Intestines; Intrinsic Factor; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Anemia; Anemia, Pernicious; Corrinoids; Hematinics; Humans; Plasma; Vitamin B 12

Topics: Anemia; Anemia, Macrocytic; Anemia, Megaloblastic; Corrinoids; Diagnosis, Differential; Humans; Vitamin B 12

Topics: Anemia; Anemia, Macrocytic; Anemia, Megaloblastic; Corrinoids; Folic Acid; Humans; Prednisolone; Vitamin B 12

Topics: Anemia; Anemia, Macrocytic; Anemia, Pernicious; Corrinoids; Humans; Vitamin B 12

Topics: Anemia; Humans; Iron; Vitamin B 12

Topics: Anemia; Anemia, Macrocytic; Anemia, Megaloblastic; Corrinoids; Humans; Vitamin B 12; Vitamins

Topics: Anemia; Anemia, Pernicious; Chromosomes; Cytogenetic Analysis; Humans; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Corrinoids; Hematinics; Vitamin B 12; Water

Topics: Anemia; Anemia, Pernicious; Gastrectomy; Humans; Postgastrectomy Syndromes; Stomach Neoplasms; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Corrinoids; Endopeptidases; Hematinics; Humans; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Hematinics; Humans; Intrinsic Factor; Vitamin B 12

Topics: Anemia; Anemia, Hypochromic; Humans; Iron; Peptic Ulcer; Postgastrectomy Syndromes; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Adenine; Anemia; Anemia, Pernicious; Bone Marrow; DNA; Energy Metabolism; In Vitro Techniques; Nucleic Acid Precursors; Nucleosides; Vitamin B 12

Topics: Administration, Oral; Anemia; Anemia, Pernicious; Corrinoids; Hematinics; Humans; Intrinsic Factor; Peptides; Vitamin B 12; Vitamins

Topics: Anemia; Anemia, Macrocytic; Anemia, Pernicious; Bile; Feces; Humans; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Cobalt Isotopes; Humans; Radiometry; Vitamin B 12; Whole-Body Counting

Topics: Anemia; Anemia, Pernicious; Cell Division; Chromosomes; Humans; Karyotype; Leukocytes; Tissue Culture Techniques; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Anemia; Anemia, Macrocytic; Anemia, Pernicious; Diabetic Neuropathies; Hematinics; Humans; Hydrogen Cyanide; Hydroxocobalamin; Neuritis; Vitamin B 12; Vitamin B Complex

Topics: Anemia; Anemia, Macrocytic; Folic Acid; Hematinics; Hematologic Tests; Humans; Vitamin B 12

Topics: Anemia; Anemia, Macrocytic; Ankyrins; Folic Acid; Humans; Spherocytosis, Hereditary; Splenectomy; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Anemia; Anemia, Pernicious; Corrinoids; Folic Acid; Hematinics; Hematocrit; Intrinsic Factor; Treatment Outcome; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Humans; Neurologic Manifestations; North Carolina; Spinal Cord; Tablets; Vitamin B 12

Topics: Anemia; Anemia, Macrocytic; Child; Cobalt Isotopes; Genetics, Medical; Hematinics; Humans; Infant; Metabolism; Prednisone; Proteinuria; Tetracycline; Urine; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Anemia; Anemia, Macrocytic; Anemia, Megaloblastic; Blood Chemical Analysis; Diagnosis; Folic Acid; Humans; L-Lactate Dehydrogenase; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Cestode Infections; Humans; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Anemia; Anemia, Sickle Cell; Avitaminosis; Erythropoiesis; Folic Acid; Folic Acid Deficiency; Humans; Vitamin B 12; Vitamin B Deficiency

Topics: Agammaglobulinemia; Anemia; Anemia, Hypochromic; Anemia, Pernicious; Blood Proteins; Electrophoresis; Geriatrics; Humans; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Anemia; Anemia, Pernicious; Central Nervous System Diseases; Corrinoids; Diagnosis, Differential; Folic Acid; Geriatrics; Humans; Intracranial Embolism; Intracranial Embolism and Thrombosis; Metabolism; RNA; Toxicology; Vitamin B 12; Vitamin B Complex; Vitamins

Topics: Achlorhydria; Anemia; Anemia, Pernicious; Atrophy; Chemical Phenomena; Chemistry; Erythropoiesis; Gastric Juice; Gastric Mucosa; Gastritis; Gastrointestinal Hormones; Humans; Intrinsic Factor; Metabolism; Peptic Ulcer; Pharmacology; Physiology; Vitamin B 12

Topics: Anemia; Anemia, Hypochromic; Anemia, Pernicious; Blood Cell Count; Folic Acid; Hemoglobinometry; Humans; Iron; Reticulocytes; Sulfates; Thalassemia; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Corrinoids; Humans; Intrinsic Factor; Metabolism; Postgastrectomy Syndromes; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Cobalt Isotopes; Corrinoids; Diagnosis, Differential; Hematinics; Humans; Neurologic Manifestations; Primary Myelofibrosis; Vitamin B 12; Vitamin B Complex

Topics: Anemia; Blood Chemical Analysis; Blood Protein Electrophoresis; Blood Sedimentation; Corrinoids; Eosinophils; gamma-Globulins; Hematinics; Humans; Lathyrism; Leukocyte Count; Vitamin B 12

Topics: Anemia; Cestode Infections; Cobalt Isotopes; Humans; Intestine, Small; Intestines; Radioisotopes; Radionuclide Imaging; Schilling Test; Vitamin B 12

Topics: Anemia; Anemia, Aplastic; Blood Chemical Analysis; Gastritis; Hematopoiesis; Humans; Peptic Ulcer; Postgastrectomy Syndromes; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Antibodies; Antigen-Antibody Reactions; Biological Assay; Child; Cobalt Isotopes; Gastric Juice; Gastroenterology; Hematinics; Humans; Intrinsic Factor; Radioisotopes; Radionuclide Imaging; Vitamin B 12

Topics: Anemia; Anemia, Macrocytic; Anemia, Pernicious; Corrinoids; Enterobacter aerogenes; Euglena; Humans; Lactobacillus; Pharmacology; Pigments, Biological; Reticulocytes; Vitamin B 12

Topics: Anemia; Anemia, Macrocytic; Anemia, Megaloblastic; Anemia, Pernicious; Humans; Pelger-Huet Anomaly; Sex Chromatin; Vitamin B 12

Topics: Absorption; Anemia; Anemia, Pernicious; Corrinoids; Glutamates; Glutamic Acid; Humans; Intrinsic Factor; Schilling Test; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Blood Cell Count; Czechoslovakia; Folic Acid; Hemoglobinometry; Humans; Intrinsic Factor; Vitamin B 12

Topics: Anemia; Anemia, Macrocytic; Anemia, Megaloblastic; Black People; Ethnology; Humans; India; South Africa; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Anemia; Anemia, Hypochromic; Blood Sedimentation; Chromium Isotopes; Colitis, Ulcerative; Feces; Gastrointestinal Hemorrhage; Hemorrhage; Humans; Iron; Iron Isotopes; Occult Blood; Radioisotopes; Radionuclide Imaging; Vitamin B 12

Topics: Adenocarcinoma; Anemia; Anemia, Pernicious; Biological Assay; Blood; Cobalt Isotopes; Gastrectomy; Gastric Acidity Determination; Geriatrics; Histamine; Humans; Intrinsic Factor; Lactobacillus; Liver; Lymphoma; Schilling Test; Stomach Neoplasms; Urine; Vitamin B 12

Topics: Anemia; Benzene; Benzimidazoles; Blood Cell Count; Blood Chemical Analysis; Blood Coagulation Factors; Blood Coagulation Tests; Ferritins; Hematinics; Iron; Propionates; Rabbits; Research; Sulfhydryl Compounds; Toxicology; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Arteriosclerosis; Atherosclerosis; Avitaminosis; Folic Acid; Geriatrics; Humans; Vitamin B 12; Vitamin B Complex

Topics: Anemia; Diagnosis; Humans; India; Infant; Intellectual Disability; Pigmentation Disorders; Syndrome; Tremor; Vitamin B 12

Topics: Anemia; Anemia, Macrocytic; Anemia, Megaloblastic; Bone Marrow Examination; Fatty Liver; Folic Acid; Gastrectomy; Hemochromatosis; Hemosiderosis; Humans; Iron; Liver Cirrhosis; Vitamin B 12; Vitamin B Deficiency

Topics: Adrenal Cortex Hormones; Adrenocorticotropic Hormone; Anemia; Anemia, Aplastic; Ascorbic Acid; Classification; Corrinoids; Electrocardiography; Folic Acid; Humans; Liver Extracts; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Blood Chemical Analysis; Vitamin B 12

Topics: Anemia; Anemia, Macrocytic; Anemia, Megaloblastic; Ascorbic Acid; Asian People; Blood Chemical Analysis; Bone Marrow Examination; Dietary Carbohydrates; Dietary Proteins; Folic Acid; Folic Acid Deficiency; Leucovorin; Lipids; Myanmar; Vitamin B 12

Topics: Adenine Nucleotides; Adenosine Triphosphatases; Adenosine Triphosphate; Anemia; Anemia, Hypochromic; Blood Transfusion; Deficiency Diseases; Humans; Infant; Liver Extracts; NAD; Vitamin B 12

Topics: Anemia; Anemia, Hypochromic; Anemia, Macrocytic; Duodenal Ulcer; Gastrectomy; Humans; Pathology; Peptic Ulcer; Postgastrectomy Syndromes; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Celiac Disease; Cobalt Isotopes; Gastrectomy; Ileitis; Physiology; Radioisotopes; Urine; Vitamin B 12

Topics: Anemia; Corrinoids; Hematinics; Hemochromatosis; Hepatolenticular Degeneration; Humans; Iron; Pharmacology; Thiamine; Thioctic Acid; Vitamin B 12

Topics: Adrenocorticotropic Hormone; Anemia; Anemia, Myelophthisic; Anti-Bacterial Agents; Ascorbic Acid; Benzene; Biopsy; Blood Transfusion; Cortisone; Female; Hematologic Diseases; Hematology; Leukemia; Liver Extracts; Mortality; Occupational Diseases; Pathology; Poisoning; Prednisolone; Prednisone; Pregnancy; Pregnancy Complications; Pregnancy Complications, Hematologic; Tetracycline; Toxicology; Vasopressins; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Diagnosis, Differential; Endopeptidases; Folic Acid; Humans; Radioisotopes; Vitamin B 12; Vitamin B 12 Deficiency; Vitamin B Deficiency

Topics: Anemia; Anemia, Aplastic; Ascorbic Acid; Bilirubin; Blood Cell Count; Blood Chemical Analysis; Blood Transfusion; Bone Marrow Examination; Child; Flavonoids; Folic Acid; Hematopoietic System; Humans; Infant; Infant, Newborn; Leukopenia; Osteoporosis; Prednisolone; Prednisone; Pyridoxine; Radiography; Riboflavin; Testosterone; Thiamine; Thrombocytopenia; Vitamin B 12

Topics: Anemia; Anemia, Macrocytic; Anemia, Pernicious; Celiac Disease; Cobalt Isotopes; Humans; Intrinsic Factor; Schilling Test; Urine; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Cobalt Isotopes; Diagnosis, Differential; Hematinics; Humans; Myelitis; Neuritis; Neurologic Manifestations; Psychotic Disorders; Schilling Test; Urine; Vitamin B 12

Topics: Anemia; Anemia, Hypochromic; Anemia, Iron-Deficiency; Ascorbic Acid; Blood Transfusion; Erythrocytes; Humans; Statistics as Topic; Vitamin B 12; Vitamin B Complex

Topics: Anemia; Anemia, Aplastic; Ascorbic Acid; Blood Transfusion; Child; Corrinoids; Cortisone; Diagnosis; Humans; Iron; Rutin; Vitamin B 12; Vitamin K

Topics: Anemia; Anemia, Megaloblastic; Humans; Infant; Infant Nutrition Disorders; Kwashiorkor; Protein-Energy Malnutrition; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Cobalt; Cobalt Radioisotopes; Corrinoids; Humans; Schilling Test; Vitamin B 12

Topics: Anemia; Anemia, Myelophthisic; Anemia, Pernicious; Hematinics; Vitamin B 12

Topics: Anemia; Anemia, Myelophthisic; Biochemical Phenomena; Gastroenterology; Humans; Nervous System Diseases; Schilling Test; Vitamin B 12

Topics: Anemia; Biochemical Phenomena; Folic Acid; Hemoglobins; Humans; Iron; Vitamin B 12

Topics: Anemia; Anemia, Myelophthisic; Anemia, Pernicious; Vitamin B 12

Topics: Achlorhydria; Anemia; Corrinoids; Gastrectomy; Hematinics; Humans; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Anemia; Bone Marrow; Gastrectomy; Hemoglobins; Humans; Iron; Vitamin B 12; Vitamin B 12 Deficiency; Vitamin B Complex

Topics: Anemia; Anemia, Myelophthisic; Blood Cells; Corrinoids; Hematinics; Humans; Leukemia, Erythroblastic, Acute; Vitamin B 12

Topics: Anemia; Gastrectomy; Humans; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Anemia; Anemia, Pernicious; Cobalt; Corrinoids; Humans; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Administration, Oral; Anemia; Anemia, Pernicious; Corrinoids; Glutamates; Glutamic Acid; Vitamin B 12

Topics: Anemia; Humans; Vitamin B 12; Vitamin B 12 Deficiency; Vitamin B Complex

Topics: Adult; Anemia; Anemia, Megaloblastic; Folic Acid; Glutamates; Humans; Thiamine; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Hematinics; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Corrinoids; Hematinics; Hematologic Diseases; Humans; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Delayed-Action Preparations; Humans; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Child; Cobalt Isotopes; Corrinoids; Hematinics; Humans; Intrinsic Factor; Schilling Test; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Cell Division; Cell Nucleus; DNA; Erythrocytes; Histones; Megaloblasts; Vitamin B 12

Topics: Anemia; Cobalt; Copper; Corrinoids; Hematinics; Humans; Iron; Liver Extracts; Lysine; Vitamin B 12; Vitamin B Complex

Topics: Anemia; Anemia, Macrocytic; Anemia, Megaloblastic; Corrinoids; Folic Acid; Humans; Vitamin B 12

Topics: Anemia; Anemia, Hypochromic; Anemia, Pernicious; Hematinics; Humans; Iron; Leukemia; Serum; Thrombocytopenia; Vitamin B 12; Vitamins

Topics: Anemia; Anemia, Pernicious; Folic Acid; Hematinics; Humans; Hypotension; Hypotension, Orthostatic; Posture; Vitamin B 12

Topics: Alkalies; Anemia; Anemia, Pernicious; Bacillus; Biological Assay; Corrinoids; Liver; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Humans; Leukemia; Leukemia, Lymphocytic, Chronic, B-Cell; Leukemia, Lymphoid; Lymphocytes; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Humans; Intestinal Absorption; Intestines; Liver; Vitamin B 12

Topics: Anemia; Anemia, Megaloblastic; Anemia, Pernicious; Folic Acid; Radioisotopes; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Corrinoids; Humans; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Anemia; Anemia, Pernicious; Cobalt Isotopes; Hematinics; Humans; Intrinsic Factor; Vitamin B 12

Topics: Anemia; Humans; Vitamin B 12; Vitamin B Complex; Vitamins

Topics: Anemia; Anemia, Pernicious; Cardia; Esophageal Diseases; Esophagus; Hematinics; Vitamin B 12; Vomiting

Topics: Administration, Oral; Anemia; Anemia, Pernicious; Cobalt Isotopes; Diagnostic Tests, Routine; Humans; Radioactivity; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Delayed-Action Preparations; Humans; Vitamin B 12; Vitamins

Topics: Anemia; Anemia, Macrocytic; Corrinoids; Folic Acid; Liver Extracts; Vitamin B 12

In 21 patients with megaloblastic anaemia associated with the tropical malabsorption syndrome serum vitamin B(12) levels have been measured serially before and during parenteral folic acid therapy. In 11 patients there was a significant rise in serum B(12) levels, reaching a peak three to 17 days after starting the folic acid. In three of these cases, absorption of labelled B(12) was the same before and after the administration of folic acid. In two cases there was a fall in serum B(12) levels and in seven there was no change. In one case small amounts of folic acid produced no change in serum B(12) levels, whereas larger doses produced a prompt but transient rise.

Topics: Anemia; Anemia, Megaloblastic; Folic Acid; Humans; Seasons; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Hematinics; Liver; Liver Extracts; Vitamin B 12

Topics: Anemia; Animals; Cestode Infections; Diphyllobothriasis; Diphyllobothrium; Folic Acid; Humans; Vitamin B 12; Vitamin B Complex

Topics: Anemia; Anemia, Pernicious; Biochemical Phenomena; Corrinoids; Hematinics; Humans; Schilling Test; Vitamin B 12

Topics: Anemia; Anemia, Hemolytic; Corrinoids; Hematinics; Hematologic Diseases; Liver Extracts; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Child; Folic Acid; Hematinics; Humans; Infant; Vitamin B 12

Topics: Anemia; Child; Hematinics; Humans; Infant; Vitamin B 12

Topics: Anemia; Corrinoids; Hematinics; Sorbitol; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Hematinics; Humans; Myxedema; Polycythemia; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Corrinoids; Glucose; Glucose Tolerance Test; Hematinics; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Liver Extracts; Vitamin B 12

Topics: Anemia; Anemia, Megaloblastic; Anticonvulsants; Corrinoids; Hematinics; Vitamin B 12

Topics: Administration, Oral; Anemia; Anemia, Pernicious; Gastric Juice; Humans; Intrinsic Factor; Vitamin B 12

Topics: Anemia; Anemia, Megaloblastic; Vitamin B 12

A method for the measurement of serum folic acid activity is described, which is a modification of previous methods. The material in serum with activity for L. casei is made up of a stable and a labile component. The amount of stable component in normal subjects and patients with megaloblastic anaemia is similar. The amount of labile component varies. In patients with folic acid deficiency none is present; in normal subjects it constitutes between 65 and 94% of the total serum L. casei activity. The labile component appears to be an index of folic acid metabolism, and the assay of total serum L. casei activity is therefore a valuable method for differentiating patients requiring treatment with folic acid from normal subjects and patients with primary vitamin B(12) deficiency. Normal subjects had serum folic acid levels from 5.9 to 21.0 mmug./ml. (mean 9.9 mmug./ml. +/- 0.3 mmug./ml. S.E.). In patients with megaloblastic anaemia requiring treatment with folic acid, other than megaloblastic anaemia of pregnancy, the levels were less than 4.0 mmug./ml. Patients with uncomplicated pernicious anaemia had levels from 6.0 to 27.0 mmug./ml. (mean 16.6 mmug./ml. +/- 1.1 mmug./ml. S.E.). The mean level in this group was higher than in normal subjects, and the highest levels of all were found in patients with subacute combined degeneration of the cord with minimal anaemia (range 14.4 to 36.8 mmug./ml.; mean 24.8 mmug./ml. +/- 2.4 mmug./ml. S.E.). The L. casei activity of the labile component is lost during autoclaving or storage at -20 degrees C. This loss can be prevented during autoclaving by using adequate amounts of ascorbic acid in the phosphate buffer used to dilute the serum for assay and by adding ascorbic acid to serum that is to be stored. Moreover, the activity lost during the storage of serum not protected by ascorbic acid could be restored, for periods up to three months, by adding ascorbic acid to this serum before assay.

Topics: Anemia; Anemia, Macrocytic; Anemia, Pernicious; Biological Assay; Female; Folic Acid; Folic Acid Deficiency; Hematologic Tests; Humans; Pregnancy; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Anemia; Anemia, Pernicious; Corrinoids; Hematinics; Tracheophyta; Vitamin B 12

Topics: Anemia; Corrinoids; Erythropoiesis; Folic Acid; Folic Acid Deficiency; Hematinics; Humans; Vitamin B 12; Vitamin B 12 Deficiency

This paper demonstrates that the hepatic surface counting technique is a reliable and satisfactory method of estimating the absorption of radioactive vitamin B(12). It does not require the collection of faeces or urine and is therefore particularly useful in studying out-patients.

Topics: Anemia; Anemia, Pernicious; Celiac Disease; Feces; Gastrectomy; Humans; Ileum; Liver; Vitamin B 12

Topics: Anemia; Anemia, Hemolytic; Anemia, Hemolytic, Congenital Nonspherocytic; Erythrocytes; Humans; Vitamin B 12

Topics: Anemia; Animals; Corrinoids; Erythrocyte Count; Hematinics; Rabbits; Reticulocytes; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Humans; Leukemia; Leukemia, Myeloid; Vitamin B 12

Topics: Anemia; Corrinoids; Humans; Iron; Phenylhydrazines; Vitamin B 12; Vitamin B 6; Vitamin B Complex; Vitamins

Topics: Anemia; Anemia, Megaloblastic; Celiac Disease; Folic Acid; Humans; Vitamin B 12

Topics: Anemia; Anemia, Megaloblastic; Child; Humans; Infant; Proteinuria; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Administration, Oral; Aged; Aged, 80 and over; Anemia; Corrinoids; Geriatrics; Hematinics; Iron; Liver Extracts; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Gastric Juice; Intrinsic Factor; Liver; Vitamin B 12

Topics: Anemia; Anemia, Hypochromic; Child; Humans; Infant; Intestine, Small; Intestines; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Anemia; Anemia, Pernicious; Gastric Juice; Hematinics; Histamine; Humans; Research; Vitamin B 12; Vitamins

Topics: Anemia; Anemia, Pernicious; Corrinoids; Gastric Juice; Humans; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Corrinoids; Gastric Juice; Hematinics; Intrinsic Factor; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Corrinoids; Hematinics; Humans; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Biochemical Phenomena; Humans; Prednisone; Tracheophyta; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Humans; Prednisone; Vitamin B 12

Topics: Anemia; Anemia, Megaloblastic; Hematinics; Humans; Vitamin B 12; Vitamin B Complex; Vitamins

Topics: Anemia; Child; Chronic Disease; Cobalt; Humans; Infant; Propionates; Vitamin B 12

The absorption of (60)CoB(12) has been studied in a group of patients suffering from megaloblastic anaemia associated with pregnancy and in a control group. The mean urinary excretion of (60)CoB(12) in the patients with megaloblastic anaemia is not significantly different from that of the control group. Five of the 30 patients showed a value towards the lower limit of normal, but the serum vitamin B(12) content in this group was within the normal range. Malabsorption of vitamin B(12) does not appear to play a significant role in the pathogenesis of this form of megaloblastic anaemia.

Topics: Anemia; Anemia, Megaloblastic; Female; Humans; Pregnancy; Pregnancy Complications; Reference Values; Vitamin B 12

Topics: Anemia; Anemia, Megaloblastic; Folic Acid; Humans; Vitamin B 12

Topics: Anemia; Anemia, Hypochromic; Anemia, Iron-Deficiency; Corrinoids; Humans; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Corrinoids; Humans; Stomach; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Humans; Schilling Test; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Hematinics; Humans; Kinetics; Leukemia; Leukemia, Myelogenous, Chronic, BCR-ABL Positive; Leukemia, Myeloid; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Ascorbic Acid; Bone Marrow; Folic Acid; Humans; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Humans; Vitamin B 12

Urinary amino-acid chromatograms from 23 patients with megaloblastic anaemia have been studied before and after therapy. The most consistent abnormality was an increased taurine or increased taurine/glycine ratio. This was not related directly to deficiency of vitamin B(12) or folic acid or to the degree of anaemia.

Topics: Amino Acids; Anemia; Anemia, Megaloblastic; Folic Acid; Humans; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Biochemical Phenomena; Cobalt; Cobalt Radioisotopes; Humans; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Corrinoids; Hematinics; Humans; Peripheral Nervous System Diseases; Vitamin B 12

Topics: Anemia; Anemia, Megaloblastic; Corrinoids; Hematinics; Humans; Vitamin B 12

Topics: Anemia; Colitis; Corrinoids; Hematinics; Humans; Iron; Serum; Stomach; Stomach Diseases; Vitamin B 12; Vitamins

Topics: Anemia; Anemia, Pernicious; Corrinoids; Hematinics; Tracheophyta; Vitamin B 12

Topics: Anemia; Anemia, Megaloblastic; Anticonvulsants; Corrinoids; Hematinics; Humans; Hydantoins; Phenobarbital; Vitamin B 12

Topics: Administration, Oral; Anemia; Anemia, Pernicious; Hematinics; Peptides; Vitamin B 12

Topics: Anemia; Edema; Folic Acid; Humans; Iron; Vitamin B 12

Topics: Anemia; Corrinoids; Hematinics; Humans; Vitamin B 12; Vitamin B Complex

Topics: Anemia; Anemia, Pernicious; Biochemical Phenomena; Humans; Prednisone; Tracheophyta; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Corrinoids; Hematinics; Humans; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Body Fluids; Hematinics; Humans; Schilling Test; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Corrinoids; Folic Acid; Hematinics; Tracheophyta; Vitamin B 12

Topics: Anemia; Animals; Erythrocytes; Phenylhydrazines; Rabbits; Vitamin B 12; Vitamin B Complex

Topics: Anemia; Anemia, Pernicious; Calcium; Humans; Ions; Leadership; Steatorrhea; Vitamin B 12; Vitamins

Topics: Anemia; Anemia, Pernicious; Corrinoids; Diagnosis, Differential; Humans; Schilling Test; Vitamin B 12

Topics: Anemia; Anemia, Hypochromic; Corrinoids; Humans; Iron; Medical Records; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Anemia; Chromatography; Corrinoids; Hematinics; Liver Extracts; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Humans; Vitamin B 12

Topics: Anemia; Animals; Corrinoids; Lead Poisoning; Liver Extracts; Rabbits; Vitamin B 12; Vitamin B Complex

Topics: Anemia; Gastric Juice; Glutamates; Glutamic Acid; Hematinics; Intrinsic Factor; Vitamin B 12; Vitamin B Complex

Topics: Anemia; Anemia, Pernicious; Cobalt; Cobalt Radioisotopes; Hematinics; Humans; Schilling Test; Vitamin B 12

Topics: Anemia; Celiac Disease; Hematinics; Humans; Vitamin B 12

Topics: Anemia; Anemia, Megaloblastic; Folic Acid Deficiency; Humans; Vitamin B 12; Vitamin B Complex

Topics: Anemia; Body Fluids; Humans; Reference Values; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Dental Care; Humans; Vitamin B 12

Topics: Achlorhydria; Anemia; Anemia, Pernicious; Endopeptidases; Gastric Juice; Humans; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Calcium; Calcium, Dietary; Humans; Intestines; Ions; Steatorrhea; Vitamin B 12

Topics: Anemia; Anemia, Hemolytic; Erythrocytes; Humans; Isotopes; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Corrinoids; Gastric Juice; Hematinics; Vitamin B 12

Topics: Adrenal Cortex Hormones; Anemia; Anemia, Pernicious; Humans; Intestines; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Corrinoids; Gastric Juice; Hematinics; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Corrinoids; Genetic Predisposition to Disease; Hematinics; Humans; Vitamin B 12

Topics: Anemia; Hematinics; Humans; Iron; Vitamin B 12

Topics: Anemia; Anemia, Megaloblastic; Anti-Bacterial Agents; Humans; Liver Extracts; Prednisone; Tetracycline; Vitamin B 12; Vitamin B Complex

Topics: Anemia; Humans; Liver Extracts; Pediatrics; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Cobalt; Corrinoids; Hematinics; Humans; Vitamin B 12

Topics: Anemia; Female; Humans; Pregnancy; Pregnancy Complications; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Cobalt; Cobalt Radioisotopes; Eating; Humans; Male; Radiometry; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Corrinoids; Gastric Juice; Hematinics; Intrinsic Factor; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Hematinics; Vitamin B 12

Topics: Anemia; Gastrectomy; Hematinics; Humans; Vitamin B 12; Vitamin B Complex

Topics: Administration, Oral; Anemia; Anemia, Pernicious; Humans; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Corrinoids; Hematinics; Vitamin B 12

Topics: Anemia; Anemia, Hypochromic; Corrinoids; Hematologic Diseases; Humans; Polycythemia Vera; Vitamin B 12

Topics: Aerosols; Anemia; Anemia, Megaloblastic; Blood Platelets; Corrinoids; Humans; Reticulocytes; Vitamin B 12; Vitamin B Complex

Topics: Anemia; Anemia, Pernicious; Humans; Prednisone; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Humans; Intestinal Absorption; Intestines; Liver; Vitamin B 12

Topics: Anemia; Anemia, Megaloblastic; Child; Hematinics; Humans; Infant; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Celiac Disease; Hematinics; Humans; Intestinal Absorption; Intestines; Malabsorption Syndromes; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Corrinoids; Gastric Juice; Hematinics; Humans; Intrinsic Factor; Vitamin B 12

Topics: Anemia; Anemia, Megaloblastic; Humans; Regression Analysis; Schilling Test; Vitamin B 12

Topics: Anemia; Anemia, Macrocytic; Diverticulum; Humans; Intestine, Small; Intestines; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Female; Humans; Pregnancy; Pregnancy Complications; Vitamin B 12

Topics: Anemia; Anemia, Megaloblastic; Female; Hematinics; Humans; Postpartum Period; Pregnancy; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Corrinoids; Gastric Juice; Hematinics; Intrinsic Factor; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Bone Marrow; DNA; DNA Replication; Folic Acid; Heme; Hemoglobins; Humans; In Vitro Techniques; Oxygen Consumption; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Biochemical Phenomena; Humans; Schilling Test; Tracheophyta; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Corrinoids; Hematinics; Humans; Kidney Diseases; Vitamin B 12

Topics: Anemia; Hyperthyroidism; Hypothyroidism; Vitamin B 12

Topics: Administration, Oral; Anemia; Anemia, Pernicious; Corrinoids; Gastric Juice; Humans; Intrinsic Factor; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Cobalt; Humans; Liver; Liver Function Tests; Vitamin B 12; Vitamins

Topics: Anemia; Anemia, Pernicious; Biochemical Phenomena; Humans; Radioactivity; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Animals; Cestoda; Cestode Infections; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Corrinoids; Gastric Juice; Hematinics; Intrinsic Factor; Vitamin B 12

Topics: Anemia; Anemia, Hypochromic; Animals; Corrinoids; Dogs; Hematinics; Stomach; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Corrinoids; Hematinics; Tracheophyta; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Chronic Disease; Corrinoids; Folic Acid; Hematinics; Humans; Recurrence; Vitamin B 12

Topics: Administration, Oral; Anemia; Anemia, Pernicious; Hematinics; Peptides; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Corrinoids; Hematinics; Intrinsic Factor; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Gastric Mucosa; Gastritis; Humans; Vitamin B 12

Topics: Anemia; Anemia, Megaloblastic; Hematinics; Humans; Orotic Acid; Riboflavin; Vitamin B 12; Vitamin B Complex

Topics: Anemia; Anemia, Pernicious; Erythrocytes; Hematinics; Humans; Porphyrins; Vitamin B 12

Experiments dealing with the distribution of B(12)Co(60) in the dog indicate that with time (9 months after administration) there is a shift in the distribution of the vitamin as compared to the short term experiments, as well as prolonged retention of the vitamin within various dog tissues. The heart, gastric mucosa, liver, spleen, and brain show high concentrations of the isotope in long term experiments. This distribution, in the heart for example, does not fit with an hypothetical breakdown of B(12)Co(60) complex and storage of a physiologically inactive fraction. Repeated periods of anemia produced by phenylhydrazine make it possible to demonstrate radioactive material in red cell stroma of dogs that have previously received vitamin B(12)Co(60). This radioactive material must have come from other body stores, such as liver and stomach. The high concentration of B(12)Co(60) in the gastric mucosa suggests a relationship between it and the intrinsic factor as described by Castle.

Topics: Anemia; Anemia, Hemolytic; Animals; Dogs; Gastric Mucosa; Liver; Vitamin B 12; Vitamins

Topics: Anemia; Anemia, Pernicious; Corrinoids; Hematinics; Humans; Tracheophyta; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Folic Acid; Hematinics; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Humans; Prednisone; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Corrinoids; Gastric Juice; Gastric Mucosa; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Corrinoids; Hematinics; Radioactivity; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Corrinoids; Gastric Juice; Intrinsic Factor; Vitamin B 12

Topics: Anemia; Humans; Vitamin B 12

Topics: Anemia; Humans; Vitamin B 12; Vitamin B Complex

Topics: Adsorption; Anemia; Anemia, Pernicious; Body Fluids; Carbon; Corrinoids; Hematinics; Schilling Test; Vitamin B 12

Topics: Anemia; Anemia, Megaloblastic; Humans; Thromboplastin; Vitamin B 12

Topics: Anemia; Child; Disease; Hematinics; Humans; Infant; Intestinal Diseases; Intestines; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Anemia; Anemia, Pernicious; Female; Pregnancy; Pregnancy Complications; Sulfates; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Diagnosis, Differential; Erythropoiesis; Humans; Intrinsic Factor; Multiple Sclerosis; Paraparesis, Spastic; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Anemia; Anemia, Pernicious; Corrinoids; Gastric Juice; Hematinics; Intrinsic Factor; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Corrinoids; Hematinics; Humans; Intestine, Small; Intestines; Sorbitol; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Gastric Juice; Humans; Intrinsic Factor; Vitamin B 12

Topics: Anemia; Anemia, Megaloblastic; Humans; Primidone; Vitamin B 12; Vitamin B Complex

Topics: Anemia; Anemia, Megaloblastic; Corrinoids; Folic Acid; Hematinics; Humans; Vitamin B 12

Topics: Anemia; Animals; Corrinoids; Cytochromes; Cytochromes c; Hematinics; Liver Extracts; Myocardium; Rabbits; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Folic Acid; Humans; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Corrinoids; Hematinics; Humans; Liver; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Folic Acid Deficiency; Humans; Vitamin B 12

Topics: Administration, Oral; Anemia; Anemia, Pernicious; Hematinics; Humans; Vitamin B 12

Topics: Anemia; Anemia, Hypochromic; Anemia, Sideroblastic; Child; Genetic Diseases, X-Linked; Humans; Infant; Vitamin B 12; Vitamin B Complex

Topics: Anemia; Anemia, Pernicious; Corrinoids; Hematinics; Humans; Radioactivity; Vitamin B 12

Topics: Anemia; Anemia, Macrocytic; Bone Marrow; Humans; Vitamin B 12; Vitamin B 12 Deficiency; Vitamin B Complex

Topics: Anemia; Anemia, Pernicious; Tracheophyta; Vitamin B 12

Topics: Anemia; Anemia, Megaloblastic; Anemia, Pernicious; Corrinoids; Humans; Vitamin B 12

Topics: Anemia; Anemia, Macrocytic; Diverticulum; Humans; Intestine, Small; Intestines; Vitamin B 12

Topics: Anemia; Child; Goats; Hematinics; Humans; Infant; Infant Nutritional Physiological Phenomena; Milk; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Body Fluids; Corrinoids; Hematinics; Humans; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Central Nervous System; Folic Acid; Hematopoietic System; Humans; Nervous System; Vitamin B 12

Topics: Anemia; Female; Humans; Iron; Postpartum Period; Pregnancy; Pregnancy Complications; Vitamin B 12; Vitamin B 12 Deficiency; Vitamin B Complex

Topics: Anemia; Ascorbic Acid; Folic Acid; Gastric Juice; Humans; Vitamin B 12

Topics: Administration, Oral; Anemia; Anemia, Pernicious; Gastric Juice; Hematinics; Intrinsic Factor; Vitamin B 12

Topics: Administration, Oral; Anemia; Anemia, Megaloblastic; Humans; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Gastric Juice; Humans; Intrinsic Factor; Vitamin B 12

Topics: Achlorhydria; Aged; Anemia; Ascorbic Acid; Hematologic Diseases; Humans; Iron; Polycythemia Vera; Vitamin B 12

Topics: Anemia; Endocrine System Diseases; Eukaryota; Hematologic Diseases; Humans; Leukemia; Liver Diseases; Vitamin B 12

Topics: Anemia; Anemia, Macrocytic; Folic Acid; Humans; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Hematinics; Intrinsic Factor; Vitamin B 12

Topics: Anemia; Anemia, Macrocytic; Anemia, Pernicious; Celiac Disease; Corrinoids; Diagnosis, Differential; Humans; Liver; Sprue, Tropical; Vitamin B 12

Topics: Administration, Oral; Anemia; Anemia, Pernicious; Gastric Juice; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Diagnosis, Differential; Gastrointestinal Tract; Humans; Radioisotopes; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Corrinoids; Gastric Juice; Hematinics; Tablets; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Humans; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Corrinoids; Glossitis; Humans; Mucous Membrane; Vitamin B 12

Topics: Anemia; Animals; Chlortetracycline; Dietary Supplements; Gastrectomy; Liver; Rats; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Gastric Juice; Hematinics; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Corrinoids; Hematinics; Medical Records; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Gastric Juice; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Gastric Juice; Intrinsic Factor; Vitamin B 12

Topics: Anemia; Anemia, Megaloblastic; Gastric Juice; Intrinsic Factor; Vitamin B 12; Vitamin B Complex

Topics: Anemia; Corrinoids; Endocrine System Diseases; Humans; Leukemia; Liver Diseases; Vitamin B 12

Topics: Anemia; Biochemical Phenomena; Erythrocytes; Hemolysis; Humans; Radioisotopes; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Hematinics; Humans; Radioisotopes; Radiopharmaceuticals; Vitamin B 12

Topics: Anemia; Anemia, Macrocytic; Body Fluids; Disease; Humans; Peripheral Nerves; Radioisotopes; Steatorrhea; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Animals; Cestoda; Cestode Infections; Vitamin B 12; Vitamins

Topics: Anemia; Anemia, Macrocytic; Anemia, Pernicious; Celiac Disease; Humans; Liver; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Hematinics; Humans; Probability; Schilling Test; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Hematinics; Humans; Polycythemia; Polycythemia Vera; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Humans; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Animals; Gastric Juice; Intestines; Intrinsic Factor; Rats; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Plasma; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Hematinics; Humans; Malabsorption Syndromes; Nutrition Disorders; Vitamin B 12