vitamin-b-12 and Leukopenia

Topics: Alcoholism; Animals; Blood Platelets; Bone Marrow; Dogs; Erythropoiesis; Ethanol; Folic Acid Antagonists; Hematopoiesis; Humans; Leukocytes; Leukopenia; 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

To document correlation between vitamin B12 deficiency and severity of thrombocytopenia, platelate recovery and duration of hospital stay in dengue fever patients.. This prospective observationl study was done in dengue fever patient with severe prolonged thrombocytopenia (<20,000 µl and > 2 days duration). Patient with underlying malignancy, hematological disorders, septicemia, or use of any drug which may cause thrombocytopenia, were excluded. Standard statistical methods were used.. Total 40 subjects were included in current study. Twenty one were male and mean age was 25±12 years. Forty percent sujects were having B12 level < 200 pg/L and mean B12 level was 336.9±362.36 pg/L. SDP requirement was highest in B12<100 pg/L group was (3±1.41) as compmared to other groups Time required for recovery of platelates to 20000/µl thresold, was also highest in B12<100 pg/L group (5.75±0.95days) as compmared to other groups. Duration of hospital stay was also highest in B12<100 pg/L group (5.25±1.25days) as compmared to other groups. There was no relation between B12 levels and other complications of dengue like bleeding, serositis, and shock.. Our study suggests that B12 deficiency may responsible for severe thrombocytopenia; slower platelates count recovery and prolonged hospitalisation in dengue fever patients.

Topics: Adolescent; Adult; Dengue; Female; Humans; Leukopenia; Male; Prospective Studies; Thrombocytopenia; Vitamin B 12; Vitamin B 12 Deficiency; Young Adult

Although vitamin B12 deficiency is a well-known cause of hematological and neuropsychiatric illness, the presentation of combined severe pancytopenia, demyelination and prominent psychiatric impairment is rare.. We present a case of a previously healthy 55-year-old East African man with severe vitamin B12 deficiency (serum vitamin B12 22pmol/L) secondary to pernicious anemia. He had a severe hypoproliferative megaloblastic anemia with hemolysis (hemoglobin 61g/L, mean corpuscular volume 99fL, reticulocytes 0.8%, haptoglobin undetectable), leukopenia (2.7×109/L), thrombocytopenia (96×109/L), ataxia with central demyelination, and megaloblastic madness. The patient's anemia, myelopathy and psychiatric condition responded well to parenteral vitamin B12 replacement therapy, with significant improvement seen within weeks.. Hematological manifestations of vitamin B12 deficiency are typically inversely correlated with the presence and severity of neuropsychiatric impairment. Although uncommon, a presentation with severe hematological and neuropsychiatric disease can occur, as illustrated by this case. Its presence may help guide diagnosis as well as provide clinically important prognostic information.

Topics: Anemia, Megaloblastic; Diagnosis, Differential; Diagnostic Imaging; Humans; Leukopenia; Male; Mental Disorders; Middle Aged; Thrombocytopenia; Vitamin B 12; Vitamin B 12 Deficiency

Folate and vitamin B(12) metabolism are essential for de novo purine synthesis, and several defects in these pathways have been associated with immunodeficiency. Here we describe the occurrence of severe combined immunodeficiency (SCID) with megaloblastic anemia, leukopenia, atypical hemolytic uremic syndrome, and neurologic abnormalities in which hydroxocobalamin and folate therapy provided partial immune reconstitution. Whole exome sequencing identified compound heterozygous mutations in the MTHFD1 gene, which encodes a trifunctional protein essential for processing of single-carbon folate derivatives. We now report the immunologic details of this novel genetic cause of SCID and the response to targeted metabolic supplementation therapies. This finding expands the known metabolic causes of SCID and presents an important diagnostic consideration given the positive impact of therapy.

Topics: 3-Hydroxyacyl CoA Dehydrogenases; Anemia, Megaloblastic; Bone Marrow Examination; Cardiomyopathies; Combined Modality Therapy; DNA Mutational Analysis; Drug Combinations; Drug Therapy, Combination; Exome; Female; Genetic Carrier Screening; Humans; Hydroxocobalamin; Immunization, Passive; Infant; Infant, Newborn; Leukopenia; Lipid Metabolism, Inborn Errors; Methylenetetrahydrofolate Dehydrogenase (NADP); Minor Histocompatibility Antigens; Mitochondrial Myopathies; Mitochondrial Trifunctional Protein; Nervous System Diseases; Opportunistic Infections; Peripheral Nervous System Diseases; Pneumonia, Pneumocystis; Retinitis Pigmentosa; Rhabdomyolysis; Sequence Analysis, DNA; Severe Combined Immunodeficiency; Sulfadoxine; Trimethoprim; Vitamin B 12

Folate-deficiency anaemia occurs in about 4 per 100 000 people, although severe cases causing moderate pancytopenia are rarer. We present the case of a significant folate deficiency in a 50-year-old alcoholic with a background of mild liver impairment and recurrent nasal and rectal bleeding. Her blood tests showed profound macrocytic anaemia with haemoglobin 2.6 g/dl, leucopoenia with white cell count 3.2 × 10(9)/litre and thrombocytopenia with platelets 17 × 10(9)/litre. Serum folate was 0.8 ng/ml (normal 2.5-13.5 ng/ml) confirming severe deficiency. Despite these life-threatening results, the patient was stable, alert and was keen to avoid admission. Medical management of the anaemia included slow transfusion of red cells and one unit of platelets in view of haemorrhagic symptoms, two injections of vitamin B12 while awaiting assays and oral folic acid. A rapid improvement in the leucopoenia and thrombocytopenia resulted and no additional complications were encountered.

Topics: Anemia, Macrocytic; Combined Modality Therapy; Epistaxis; Erythrocyte Transfusion; Female; Folic Acid; Folic Acid Deficiency; Gastrointestinal Hemorrhage; Humans; Leukopenia; Liver Diseases, Alcoholic; Middle Aged; Pancytopenia; Platelet Transfusion; Thrombocytopenia; 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

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

A spontaneous oscillation of the white blood cell count was observed in a 58 year old man with chronic myelogenous leukemia (CML). Similar cyclic variations were noted in the platelet and reticulocyte counts with no apparent alterations in marrow cellularity to account for such changes. Since direct correlation was noted between white blood cells, platelets, and reticulocyte counts versus spleen size, it suggests that splenic hemopoiesis may be responsible for these cyclic changes. A possible inverse relationship between colony-stimulating factor (CSF) activity and the white blood cell count was noted, suggesting that CSF may be the humoral agent controlling granulocyte production. A direct correlation between the white blood cell count and serum unsaturated vitamin B12 binding capacity (UBBC) and lysozyme was also noted and further supports the concept that the latter two are measures of the granulocyte pool and metabolism. An inverse relationship between CSF activity and the UBBC suggests that these may be two different entities. Finally a modified form of standard chemotherapy may be effective in inducing remission in cases of CML with marked cyclic leukocytosis-leukopenia.

Topics: Alkaline Phosphatase; Blood Cell Count; Blood Platelets; Bone Marrow Examination; Colony-Stimulating Factors; Erythropoietin; Hemoglobins; Humans; Karyotyping; Leukemia, Myeloid; Leukocyte Count; Leukocytosis; Leukopenia; Male; Middle Aged; Muramidase; Periodicity; Reticulocytes; Spleen; Vitamin B 12

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

Topics: Anemia, Macrocytic; Animals; Asthenia; Body Weight; Diarrhea; Feeding and Eating Disorders; FIGLU Test; Folic Acid; Folic Acid Deficiency; Gingivitis; Humans; Leukopenia; Liver; Male; Malonates; Papio; Thrombocytopenia; Vitamin B 12

Topics: Adult; Aged; Alcoholism; Bone Marrow Cells; Bone Marrow Examination; Female; Folic Acid Deficiency; Humans; Leukocyte Count; Leukopenia; Liver Function Tests; Male; Middle Aged; Protein Binding; Vitamin B 12

Topics: Adult; Anemia, Macrocytic; Bone Marrow; Female; Folic Acid; Humans; Hydroxyurea; Leukopenia; Male; Middle Aged; Psoriasis; Vitamin B 12

Topics: Adolescent; Adult; Aged; Anemia, Macrocytic; Drug-Related Side Effects and Adverse Reactions; Gastrectomy; Humans; Intestine, Small; Leukopenia; Middle Aged; Thrombocytopenia; Vitamin B 12

Topics: Acute Disease; Adolescent; Adult; Afibrinogenemia; Autopsy; Biopsy; Blood Proteins; Bone Marrow; Child; Disseminated Intravascular Coagulation; Female; Hemorrhage; Humans; Leukemia, Myeloid, Acute; Leukopenia; Liver; Male; Middle Aged; Protein Binding; Vitamin B 12

Topics: Adult; Anemia, Macrocytic; Bone Marrow Examination; Child; Female; Folic Acid; Folic Acid Deficiency; Hemoglobinometry; Humans; Infant; Leukopenia; Malabsorption Syndromes; Male; Pregnancy; Thrombocytopenia; Uganda; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Bone Marrow; Cytarabine; Folic Acid; Leukemia, Monocytic, Acute; Leukopenia; Reticulocytes; Vitamin B 12

Topics: Anemia, Macrocytic; Blood Transfusion; Child; Child, Preschool; Cobalt Isotopes; Folic Acid; Humans; Leukopenia; Malabsorption Syndromes; Male; Myelitis; Proteinuria; Schilling Test; Thrombocytopenia; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Anemia; Anemia, Pernicious; Erythrocyte Count; Geriatrics; Humans; Leukemia; Leukemia, Lymphoid; Leukopenia; Neoplasms; Reticulocytes; Vitamin B 12

Topics: Corrinoids; Folic Acid; Hematinics; Humans; Leukopenia; Oxytetracycline; Radiation Injuries; Radiation Injuries, Experimental; Vitamin B 12; Vitamin B Complex

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: Corrinoids; Leukocyte Count; Leukopenia; Mechlorethamine; Nitrogen Mustard Compounds; Vitamin B 12

Topics: Animals; Corrinoids; Leukocytes; Leukopenia; Methylthiouracil; Rats; Vitamin B 12; Vitamin B Complex

Topics: Hematinics; Humans; Leukopenia; Radiation; Vitamin B 12; Vitamin B Complex