vitamin-b-12 and Liver-Diseases

Homocysteine (Hcy) is methylated by methionine synthase to form methionine with methyl-cobalamin as a cofactor. The reaction demethylates 5-methyltetrahydrofolate to tetrahydrofolate, which is required for DNA and RNA synthesis. Deficiency of either of the cobalamin (Cbl) and/or folate cofactors results in elevated Hcy and megaloblastic anemia. Elevated Hcy is a sensitive biomarker of Cbl and/or folate status and more specific than serum vitamin assays. Elevated Hcy normalizes when the correct vitamin is given. Elevated Hcy is associated with alcohol use disorder and drugs that target folate or Cbl metabolism, and is a risk factor for thrombotic vascular disease. Elevated methionine and cystathionine are associated with liver disease. Elevated Hcy, cystathionine, and cysteine, but not methionine, are common in patients with chronic renal failure. Higher cysteine predicts obesity and future weight gain. Serum S-adenosylhomocysteine (AdoHcy) is elevated in Cbl deficiency and chronic renal failure. Drugs that require methylation for catabolism may deplete liver S-adenosylmethionine and raise AdoHcy and Hcy. Deficiency of Cbl or folate or perturbations of their metabolism cause major changes in sulfur amino acids.

Topics: Alcoholism; Amino Acids, Sulfur; Anemia, Megaloblastic; Biomarkers; Cardiovascular Diseases; Folic Acid; Folic Acid Deficiency; Humans; Hyperhomocysteinemia; Kidney Failure, Chronic; Liver Diseases; Nutritional Status; Obesity; S-Adenosylhomocysteine; Vitamin B 12; Vitamin B 12 Deficiency

High serum levels of vitamin B12 or cobalamin, also called hypervitaminemia B12, is a frequently underestimated biological abnormality. According to the literature, some of the entities related to this finding are solid neoplasia (primary or metastatic) and acute or chronic hematological diseases. Other causes include liver disorders, monoclonal gammapathy of undetermined significance, renal failure and, less frequently, excess of vitamin B12 intake, inflammatory or autoimmune diseases, and transient hematological disorders (neutrophilia and secondary eosinophilia). This article reports on causes of hypervitaminosis B12, our experience and a review of the literature.. Los altos niveles de vitamina B12 o cobalamina, también denominado hipervitaminosis B12 es una anormalidad analítica frecuentemente subestimada. De acuerdo con la literatura algunas de las entidades relacionadas con este hallazgo son las neoplasias sólidas (primarias o metastásicas) y las enfermedades hematológicas agudas o crónicas. Otras causas incluyen la afección hepática, la gammapatía monoclonal de significación indeterminada, la insuficiencia renal y, con menor frecuencia, un exceso de consumo de vitamina B12, enfermedades inflamatorias o autoinmunes y los trastornos hematológicos transitorios (neutrofilia y eosinofilia secundaria). Este artículo informa sobre causas de hipervitaminosis B12, nuestra experiencia y hace una revisión de la literatura.

Topics: Acute Kidney Injury; Hematologic Diseases; Humans; Liver Diseases; Neoplasms; Nutrition Disorders; Vitamin B 12

A high serum vitamin B12 level (hypercobalaminemia) is a underestimated anomaly. Clinically, it can be paradoxically accompanied by signs of deficiency, which are related to defects in tissue uptake of vitamin B12. The increase in the level of serum cobalamin occurs mainly in serious diseases that require early diagnosis: hemoblastosis, liver and kidney diseases, etc. This review presents data on the metabolism of vitamin B12 and the potential significance of increasing its level as a marker for the early diagnosis of these diseases.. Гиперкобаламинемия - синдром повышения уровня витамина B12 в сыворотке крови, значение которого в клинической практике часто недооценивается. Это явление может сопровождаться парадоксальными с клинической точки зрения признаками гиповитаминоза витамина В12, отражающими наличие функционального дефицита, обусловленного дефектами потребления витамина тканями. Этиологическими факторами повышения уровня кобаламина в сыворотке крови являются преимущественно тяжелые заболевания, при которых особое значение для прогноза имеет ранняя диагностика: солидные опухоли, злокачественные гематологические новообразования, а также заболевания печени и почек с признаками их недостаточности. В настоящем обзоре представлены данные об обмене витамина В12 и потенциальной значимости повышения его уровня как маркера ранней диагностики этих заболеваний.

Topics: Biomarkers; Humans; Kidney Diseases; Liver; Liver Diseases; Vitamin B 12; Vitamin B 12 Deficiency

Anemia is a common problem in primary care. Classification based on mean cell volume narrows the differential diagnosis and directs testing. A marked macrocytosis is characteristic of vitamin B12 and folate deficiencies, certain medications, and primary bone marrow disorders. The three most common causes of microcytic anemia are iron deficiency, thalassemia trait, and anemia of inflammation. Additional laboratory testing is required for diagnosis. Determination of the rate of development of anemia and examination of a blood smear may provide diagnostic clues to guide more specialized testing. Diagnosis of iron, vitamin B12, or folate deficiency mandates determination of the underlying cause.

Topics: Alcohol Drinking; Anemia, Iron-Deficiency; Anemia, Macrocytic; Blood Cell Count; Diagnosis, Differential; Drug-Related Side Effects and Adverse Reactions; Female; FIGLU Test; Folic Acid; Folic Acid Deficiency; Humans; Liver Diseases; Myeloproliferative Disorders; Predictive Value of Tests; Primary Health Care; United States; Vitamin B 12; Vitamin B 12 Deficiency; Women's Health

Hypercobalaminemia (high serum vitamin B12 levels) is a frequent and underestimated anomaly. Clinically, it can be paradoxically accompanied by signs of deficiency, reflecting a functional deficiency linked to qualitative abnormalities, which are related to defects in tissue uptake and action of vitamin B12. The aetiological profile of high serum cobalamin predominantly encompasses severe disease entities for which early diagnosis is critical for prognosis. These entities are essentially comprised of solid neoplasms, haematological malignancies and liver and kidney diseases. This review reflects the potential importance of the vitamin B12 assay as an early diagnostic marker of these diseases. A codified approach is needed to determine the potential indications of a search for high serum cobalamin and the practical clinical strategy to adopt upon discovery of elevated cobalamin levels. While low serum cobalamin levels do not necessarily imply deficiency, an abnormally high serum cobalamin level forms a warning sign requiring exclusion of a number of serious underlying pathologies. Functional cobalamin deficiency can thus occur at any serum level.

Topics: Biomarkers; Biomarkers, Tumor; Hematologic Diseases; Humans; Liver Diseases; Neoplasms; Transcobalamins; Vitamin B 12; Vitamin B 12 Deficiency

It is well-established that more than 8% of patients examined for vitamin B12 deficiency unexpectedly have increased plasma levels of the vitamin, but so far there are no guidelines for the clinical interpretation of such findings. In this review, we summarise known associations between high plasma cobalamin and diseases. We report associations mainly with cancer, liver and kidney diseases, but also with a number of other diagnostic entities. The pathogenic background is poorly understood and is likely to be multi-factorial, involving increased concentrations of one or both of the circulating cobalamin binding proteins, transcobalamin and haptocorrin. Based on current knowledge, we suggest a strategy for the clinical interpretation of unexpected high plasma cobalamin. Since a number of the associated diseases are critical and life-threatening, the strategy promotes the concept of 'think the worst first'. It is important to realise that high cobalamin levels can be an unspecific marker for cancer. If this can be ruled out, diseases of the liver and kidney should be considered.

Topics: Autoimmune Diseases; Communicable Diseases; Hematologic Neoplasms; Humans; Kidney Diseases; Liver Diseases; Transcobalamins; Vitamin B 12; Vitamin B 12 Deficiency

Hypervitaminemia B12 or high serum level of cobalamin B12 is a frequent and clinical underestimated abnormality. Clinically, it can be sometimes paradoxically accompanied by signs of deficiency reflecting a functional deficit in relation to qualitative abnormalities related to defects in tissue uptake and action of vitamin B12. Etiological profile of hypervitaminemias B12 has mostly serious disease entities and for which early diagnosis is crucial to the plan rather than prognostic. These entities are represented mainly by solid malignancies, hematological malignancies and liver diseases. This reflects the potential significance that may have the dosage of vitamin B12 as an early marker of diagnosis of these diseases. Codified approach is needed to determine the potential indications of the search for a hypervitaminemia B12 and practice what to do to pass before the discovery of a high serum level of cobalamin.

Topics: Hematologic Diseases; Humans; Liver Diseases; Metabolic Diseases; Models, Biological; Neoplasms; Professional Practice; Prognosis; Up-Regulation; Vitamin B 12

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

The study was made of the recent literature on controlled hypotension and its place in modern anaesthetic practice. The effects of the different techniques and drugs are outlined in this paper. The results of investigation revealed that the circulation of heart, brain, liver, and kidneys is able to tolerate a wide range of deviation of blood pressure. Hypotension induced by high doses of halothane alone, which used to be considered as an adequate measure, has recently been shown to cause such serious side-effects that it can no longer be recommended. Halothane lowers blood pressure almost exclusively by means of a reduction of the contractility of the heart muscle. Ganglionic blocking agents alone should not be used either because of their depressing effect on the heart; moreover their hypotensive effects are hard to control. The sole exception is trimetaphan but it produces other severe side-effects such as liberation of histamine. On the other hand ganglionic blocking agents combined with halothane can be recommended. The combined administration of these drugs allow an easy control of hypotension and the side effects are minimal. Only sodium-nitroprusside meets all the requirements of a hypotensive drug. It operates selectively in a peripheral vasoplegic manner without effecting the cerebral centres. Regarding the heart, no side-effect is known apart from tachycardia; cardiac output is not altered. The metabolism of sodium-nitroprusside requires precaution in dosage, as degradation takes place via the toxic compounds of cyanide. Therefore liver disease and disturbances in vitamin B12 utilisation are regarded as contraindications for the use of nitroprusside. That is also the reason why a maximum allowable dose of 10-15 gamma/kg body weight and minute should not be exceeded. Prophylactic administration of vitamin B 12a (hydroxocobalamin) should be considered in every case when nitroprusside is used.

Topics: Cardiac Output; Cerebrovascular Circulation; Coronary Circulation; Ganglionic Blockers; Halothane; Humans; Hypotension, Controlled; Kidney; Liver Circulation; Liver Diseases; Myocardial Contraction; Nitroprusside; Regional Blood Flow; Tachycardia; Vitamin B 12

Topics: Amino Acids; Dietary Carbohydrates; Dietary Fats; Dietary Proteins; Digestion; Electrolytes; Gastric Emptying; Gastrointestinal Diseases; Humans; Intestinal Absorption; Iron; Liver Diseases; Liver Function Tests; Pancreatic Diseases; Protein-Losing Enteropathies; Radionuclide Imaging; Vitamin B 12

Topics: Adrenal Cortex Hormones; Anabolic Agents; Chronic Disease; Diagnosis, Differential; Diet Therapy; Dietary Fats; Dietary Proteins; Diuretics; Hepatitis; Humans; Immunosuppressive Agents; Lactulose; Liver Cirrhosis; Liver Diseases; Long-Term Care; Penicillamine; Rest; Vitamin B 12

Topics: Bile Acids and Salts; Biliary Fistula; Biliary Tract Diseases; Cholestyramine Resin; Chylomicrons; Colloids; Colonic Diseases; Feces; Gallbladder Diseases; Gastrointestinal Diseases; Humans; Intestinal Absorption; Intestinal Fistula; Intestinal Mucosa; Lipid Metabolism; Lipids; Liver Diseases; Macromolecular Substances; Malabsorption Syndromes; Neomycin; Pancreas; Solubility; Vitamin B 12; Xylose; Zollinger-Ellison Syndrome

Topics: ABO Blood-Group System; Celiac Disease; Chronic Disease; Colitis, Ulcerative; Crohn Disease; Drainage; Esophageal Diseases; Female; Folic Acid; Gastrectomy; Gastritis; Gastrointestinal Diseases; Gastrointestinal Hemorrhage; Heavy Chain Disease; Hepatitis, Viral, Human; Humans; Hypersplenism; Intestinal Diseases; Iron; Liver Diseases; Middle Aged; Pancreatic Diseases; Vagotomy; Vitamin B 12

Topics: Biological Transport; Humans; Liver; Liver Diseases; Vitamin B 12

Topics: Adult; Animals; Biliary Tract Diseases; Child; Diabetes Mellitus; Female; Humans; Hyperglycemia; Intracranial Pressure; Liver Diseases; Pregnancy; Prenatal Care; Rats; Sorbitol; Vitamin B 12

Topics: Anemia, Hypochromic; Anemia, Macrocytic; Anemia, Pernicious; Chronic Disease; Hemoglobinometry; Hemolysis; Humans; Liver; Liver Cirrhosis; Liver Diseases; Vitamin B 12

Topics: Adenoma, Islet Cell; Carbohydrates; Cardiovascular Diseases; Celiac Disease; Diabetes Mellitus; Fatty Acids; Gastrectomy; Gastroenteritis; Glutens; Hematinics; Humans; Liver Diseases; Radiation Injuries; Vitamin B 12

Topics: Anti-Bacterial Agents; Bile Ducts, Intrahepatic; Cholangitis; Cortisone; Drainage; Hepatitis; Humans; Liver Cirrhosis; Liver Diseases; Methenamine; Sulfanilamide; Sulfanilamides; Vitamin B 12

Topics: Animals; Liver Diseases; Sheep; Sheep Diseases; Vitamin B 12

Topics: Choline; Clinical Trials as Topic; Dehydrocholic Acid; Drug Combinations; Drug Evaluation; Gallbladder Diseases; Humans; Liver; Liver Diseases; Liver Regeneration; Magnesium; Orotic Acid; Vitamin B 12

Topics: Adolescent; Adult; Aged; Clinical Trials as Topic; Cysteine; Drug Combinations; Female; Folic Acid; Humans; Liver Diseases; Liver Function Tests; Male; Middle Aged; Niacinamide; Orotic Acid; Plant Extracts; Thiamine; Time Factors; Vitamin B 12

Topics: Adult; Aged; Choline; Clinical Trials as Topic; Dehydrocholic Acid; Drug Combinations; Drug Evaluation; Female; Humans; Liver Diseases; Magnesium; Male; Middle Aged; Orotic Acid; Vitamin B 12

A controlled clinical trial comparing 2-Mercapto-Priopionyl-Glycine (2-MPG) plus B12 vitamin with B12 vitamin alone in chronic liver disease has been conducted in seven hospitals in Italy. Patients were divided into two groups on the basis of liver histology; group I included 26 patients showing histological evidence for chronic persistent hepatitis (C.P.H.) (according to De Groote et al.) whereas group II consisted of 54 patients with chronic aggressive hepatitis (C.A.H.) or compensated liver cirrhosis. Patients of each group were randomly allocated to 2-MPG plus B12 vitamin, or to placebo plus B12 vitamin, in a double-blind way. The drug (or placebo) was diluted in 500 ml of 10% Levulose, and administered intravenously; 1000 gamma of B12 vitamin were added to each bottle. Patients in the 2-MPG group received 2.5 gms of the drug daily; the treatment lasted for 30 days. The following parameters were checked in all patients on admission, and repeated at the end of treatment: Serum bilirubin, serum Cholesterol, A.P., BSP retention, Prothrombin time, S-GOT, S-GPT, Gamma-GT, Total serum Protein, serum electrophoresis, Immunoglobulins. Patients given 2-MPG showed significant decreases of serum transaminases, and improvement of BSP retention.

Topics: Amino Acids, Sulfur; Chronic Disease; Hepatitis; Humans; Liver Cirrhosis; Liver Diseases; Tiopronin; Vitamin B 12

Topics: Bilirubin; Choline; Chronic Disease; Clinical Trials as Topic; Drug Combinations; Drug Evaluation; Female; Homocysteine; Humans; Lactones; Liver; Liver Diseases; Liver Function Tests; Lung Diseases; Male; Peritonitis; Pleurisy; Silicotuberculosis; Transaminases; Tuberculosis, Pulmonary; Vitamin B 12

Topics: Adult; Aged; Choline; Chronic Disease; Drug Combinations; Evaluation Studies as Topic; Female; Homocysteine; Humans; Lactones; Liver Diseases; Liver Function Tests; Male; Middle Aged; Phosphoric Acids; Vitamin B 12

Topics: Cobalt Isotopes; Coenzymes; Humans; Hydroxocobalamin; Kidney Diseases; Liver Diseases; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Chronic Disease; Humans; Liver Diseases; Liver Extracts; Placebos; Pyridoxine; Riboflavin; Thiamine; Vitamin B 12; Vitamin B Complex

Topics: Chronic Disease; Humans; Liver Diseases; Liver Extracts; Placebos; Pyridoxine; Riboflavin; Thiamine; Vitamin B 12; Vitamin B Complex

Topics: Aldosterone; Chronic Disease; Hepatitis; Humans; Liver Cirrhosis; Liver Diseases; Nandrolone; Prednisone; Pyridoxine; Tolbutamide; Vitamin B 12

Topics: Adult; Aged; Ascorbic Acid; Blood Proteins; Clinical Trials as Topic; Folic Acid; Hepatitis; Humans; Liver Cirrhosis; Liver Diseases; Middle Aged; Nicotinic Acids; Vitamin B 12

Chronic liver disease is an immuno-compromised state is well known established fact but there are falsely elevated vitamin B12 levels in patients with chronic liver disease, which can be used as severity and prognostic marker. This study was designed to investigate the association between vitamin B12 levels and liver disease severity and long term prognosis in patients with chronic liver disease.. An observational longitudinal study was carried over a period of 6 months among indoor patients admitted in department of medicine of a tertiary care hospital in North-Eastern India. A total of 50 patients diagnosed with chronic liver disease were enrolled. Serum vitamin B12 concentration and other blood parameters were determined. The data were analyzed accordingly by descriptive statistics using Spss for the result.. The study population were predominantly male with mean age 50.80 ± 10.35. Mean total serum vitamin B12 concentration was significantly higher in patients with chronic liver disease (1639 ± 504 pg/ml) when compared to normal people (650 ± 300pg/ml). Also among patients with chronic liver disease Child-Pugh C (1858 ± 359pg/mL) had higher B12 levels when compared to those with Child-Pugh B (1076 ± 370 pg/mL). Out of 50 people, 4 were died and their mean B12 was (2113 ± 112 pg/ml).. Falsely increased B12 levels are due to increased excretion of vitamin B12 in to serum from the liver and these serum B12 levels correlates with the severity and prognosis of the patient. References Sugihara T, Koda M, Okamoto T, et al. Falsely elevated serum vitamin B12 levels were associated with the severity and prognosis of chronic viral liver disease. Yonago Acta Med 2017;60(1):31-39. Dou J, Xu W, Ye B, et al. Serum vitamin B12 levels as indicators of disease severity and mortality of patients with acute-on-chronic liver failure. Clin Chim Acta 2012;413(23-24):1809-1812.

Topics: Adult; Female; Humans; Liver Diseases; Longitudinal Studies; Male; Middle Aged; Prognosis; Vitamin B 12; Vitamin B 12 Deficiency

Our study aims to investigate molecular events associated to methyl donor deficiency (MDD) by analyzing the transcriptome and the methylome of MDD rats in liver.. Twenty-one-day-old rats born to mothers fed either with a standard diet or a MDD diet during gestation and lactation were compared. From a total of 44 000 probes for 26 456 genes, we found two gene clusters in MDD rats whose expression levels had significant differences compared with controls: 3269 overexpressed (p < 0.0009) and 2841 underexpressed (p < 0.0004) genes. Modifications of DNA methylation were found in the promoter regions of 1032 genes out of 14 981 genes. Ontological analyses revealed that these genes are mainly involved in glucose and lipid metabolism, nervous system, coagulation, ER stress, and mitochondrial function.. Putative master genes exhibiting changes in both gene expression and DNA methylation are limited to 266 genes and are mainly involved in the renin-angiotensin system (n = 3), mitochondrion metabolism (n = 18), and phospholipid homeostasis (n = 3). Most of these master genes participate in nonalcoholic fatty liver disease. The adverse effects of MDD on the metabolic process indicate the beneficial impact of folate and vitamin B12, especially during the perinatal period.

Topics: Animals; Computational Biology; Diet; DNA Methylation; Epigenomics; Female; Folic Acid; Gene Expression; Lactation; Lipid Metabolism; Liver; Liver Diseases; Maternal Nutritional Physiological Phenomena; Perinatal Care; Rats; Rats, Wistar; Reproducibility of Results; Transcriptome; Vitamin B 12

Anorexia nervosa (AN) is a complex disorder involving severe psychological manifestations and multiple organ damage, including liver dysfunction. The primary aim of this study consisted in assessing plasma levels of vitamin B12 and folates with respect to liver function enzymes considering the liver-storage properties of this vitamin.. We recruited 70 restrictive type AN adolescents and the severity of psychopathological traits was assessed using EDI-3 scale. Plasma levels of vitamin B12 , folates, transaminases (AST, ALT), gamma-glutamyl transpeptidase (GGT), alkaline phosphatase (ALP) and cholinesterase (CHE) were determined.. About 38.5% of patients displayed vitamin B12 values (H-B12) above the upper range of normal reference; 4.3% of patients had increased values of folates; 20 and 11.4% of patients displayed ALT and AST values above reference limits; none had GGT values above normal range. Albeit low CHE and ALP values were found in 55 and 20% of patients, respectively, a linear correlation with both transaminases was present only for vitamin B12 and folates; furthermore, H-B12 patients had both higher AST and ALT values. EDI- 3 subscores significantly correlated with vitamin B12 and folates plasma values and H-B12 patients displayed EDI-3 higher values.. These data suggest that plasma levels of vitamin B12 might be an early marker of liver dysfunction, possibly also related to more severe psychopathological aspects. The identification of patients with higher fasting plasma vitamin B12 levels could therefore lead to earlier and more careful refeeding interventions. Further studies will clarify the potential role of this vitamin in AN clinical practice.

Topics: Adolescent; Anorexia Nervosa; Biomarkers; Child; Esterases; Female; Folic Acid; Humans; Liver; Liver Diseases; Liver Function Tests; Male; Transferases; Vitamin B 12

Topics: Aged; Autoimmune Diseases; Female; France; Hematologic Diseases; Humans; Liver Diseases; Male; Metabolic Diseases; Neoplasms; Prevalence; Prognosis; Renal Insufficiency; Statistics as Topic; Vitamin B 12

Topics: Alcoholism; Hematologic Neoplasms; Hospital Departments; Hospitalization; Humans; Kidney Diseases; Liver Diseases; Prospective Studies; Vitamin B 12

The vitamin B12 (B12)-binding protein haptocorrin (HC) has proven to be a potentially useful biomarker in patients with fibrolamellar hepatocellular carcinoma (HCC). Little is known concerning the level of HC and other B12-related proteins in patients with HCC as compared to patients with other chronic liver diseases (CLDs) and healthy controls. We hypothesized that HC could be a biomarker of HCC.. To investigate levels of HC and B12-related proteins in HCC compared to CLDs and healthy controls.. We investigated two patient populations: A cross-sectional cohort of HCC patients (n = 130), CLD patients (n = 102) and healthy controls (n = 46) and a cohort of 38 HCC patients studied at baseline and 1, 4, and 12 weeks following ablative treatment. Patients were evaluated by standard biochemistry, Child-Pugh-score and Barcelona Clinic Liver Cancer (BCLC) classification. We analyzed total B12 by routine methods and HC, transcobalamin (TC), B12 saturated TC (holoTC), and the soluble cell surface receptor for holoTC (sCD320) by in-house enzyme-linked immunosorbent assay.. HC showed higher median (range) levels for both HCC (590 [290-5860]) and CLD patients (620 [310-4010]) compared to controls (460 [250-2020]) (p < 0.01). Total B12, TC, holoTC, and sCD320 showed elevated levels in both HCC and CLD compared to controls. Only holoTC changed following treatment, without a concurrent change in TC.. B12 and B12-related proteins (total B12, HC, TC, holoTC, and sCD320) show elevations in both HCC and CLD patients compared to controls, suggesting a relation to CLD in general rather than to primary liver cancer. Thus, HC is not useful as a biomarker for HCC.

Topics: Adult; Aged; Aged, 80 and over; Antigens, CD; Biomarkers, Tumor; Carcinoma, Hepatocellular; Case-Control Studies; Catheter Ablation; Chemoembolization, Therapeutic; Chronic Disease; Cross-Sectional Studies; Female; Humans; Liver Diseases; Liver Neoplasms; Male; Middle Aged; Receptors, Cell Surface; Transcobalamins; Vitamin B 12

When increased serum cobalamin concentrations are encountered clinically they are usually attributed to parenteral supplementation, dietary factors, or otherwise ignored. However, recently, hypercobalaminaemia has been associated with numerous diseases in humans, most notably neoplastic and hepatic disorders. The aim of this retrospective, observational, cross-sectional study was to determine the significance of increased cobalamin in cats.. In total, 237 records were retrieved and 174 cats, of various ages and sexes met the inclusion criteria. A total of 42 cats had increased serum cobalamin concentration, and had not received prior supplementation. Multiple logistic regression analysis revealed that increased serum cobalamin concentration was positively related to pedigree breed (pedigree breeds more likely to have increased cobalamin concentration, odds ratio [OR] 4.24, 95% CI 1.78-10.15, P = 0.001), to having liver disease (OR 9.91, 95% CI 3.54-27.68), and to having a solid neoplasm (OR 8.54, 95% CI 1.10-66.45).. The results of the current study suggest that increased serum cobalamin concentrations should not be ignored in cats with no history of supplementation, and investigation for underlying hepatic or neoplastic disease is warranted.

Topics: Aging; Animals; Cat Diseases; Cats; Cross-Sectional Studies; Female; Liver Diseases; Male; Neoplasms; Odds Ratio; Retrospective Studies; Risk Factors; Sensitivity and Specificity; Vitamin B 12

To identify the diseases that are associated with a high plasma concentration of vitamin B12 and to measure the strength of this association.. Retrospective study including all admissions between 1st May, 2005 and 30th April, 2008 in the UMAG pole departments (emergency, internal medicine, acute geriatrics and medical intensive care) with a test for plasma vitamin B12. The association between each of medical information system codes (solid tumors, malignant hematologic process, and renal disease) and a high or low vitamin B12 concentration was measured by odds ratios (OR) from logistic models taking into account repeated admissions, with adjustment for age and the weighted Charlson index.. Among 3702 admissions, 12% had a B12 more than 820pg/ml, 10.4% a B12 less than 180pg/ml and 77.6% a normal B12 concentration. After adjustment for age and the weighted Charlson index, high concentration of vitamin B12 was associated with interstitial renal diseases (OR 2.7; 95% CI: [1.7-4.2]), and cirrhosis or hepatitis (OR 4.3; [2.9-6.4]). After additional adjustment for these parameters, it was still associated with tumors (OR 1.8; [1.2-2.6]), malignant hematologic diseases (OR 2.1; [1.3-3.5]), metastasis (OR 2.9; [1.5-5.9]), liver metastasis (OR 6.2; [2.7-14.5]), liver carcinoma (LC) (OR 3.3; [1.1-10.4]), liver tumors other than LC (OR 4.7; [1.2-17.9]) and lymphoma (OR 3.2; [1.6-6.4]) but not with myeloma (OR 1.9; [0.6-1.4]). Low concentration of B12 was associated with myeloma (OR 2.9; [1.3-6.6]).. Finding a high plasma concentration of vitamin B12 should lead to a systematic search for a hepatic disease or a tumor, and particularly for a hepatic localization of a tumor.

Topics: Aged; Aged, 80 and over; Female; Humans; Length of Stay; Liver Diseases; Male; Middle Aged; Neoplasms; Osmolar Concentration; Prognosis; Retrospective Studies; Risk Factors; Vitamin B 12

In the liver, eNOS appears to have a central role in protecting against ischemia/reperfusion (I/R) injury. We hypothesized that tetrahydrobiopterin (BH4) would protect livers subjected to I/R injury by coupling with eNOS.. Chinese Kun Ming (KM) mice were subjected to 60 min of 70% hepatic ischemia 30 min after the administration of BH4 or saline. After reperfusion, survival was evaluated. The histologic appearance and ALT, BH4, nitrite/nitrate, 8-isoprostane, and eNOS protein expression levels were measured.. The 1-wk survival rate was 66.67% in the BH4 group and 33.33% in the saline group. The serum ALT values in the BH4 group 1, 3, 6, 12, and 24 h after reperfusion were significantly lower than those of the saline group. A histologic examination of the liver revealed only a small necrotic area in the BH4 group as opposed to massive necrosis in the saline group. The percentage values of the hepatic necrotic area 24 h after reperfusion were significantly less for the BH4 group than for the saline group. The nitrite/nitrate levels in the liver tissue were significantly increased by ~2-fold in the BH4 group compared with the saline group. The free radical indicator 8-isoprostane was reduced approximately 50% in the BH4 group compared with the saline group. Western blotting showed that the level of eNOS protein between the groups was not significantly different.. BH4 significantly improved the survival rate by reducing liver failure. This was supported by the histologic findings, and the mechanism was explored. According to the results, we suggest that BH4 prevents liver damage from I/R injury by attenuating reactive oxygen species and increasing NO synthesis, and might provide a novel and promising therapeutic option for preventing I/R injury.

Topics: Alanine Transaminase; Animals; Biopterins; Delayed Graft Function; Dinoprost; Liver; Liver Diseases; Liver Transplantation; Mice; Mice, Inbred Strains; Nitrates; Nitric Oxide Synthase Type III; Reperfusion Injury; Superoxides; Vitamin B 12

Measurement of serum cobalamin levels is routinely used to diagnose cobalamin deficiency. Surprisingly, approximately 15% of patients have high cobalamin levels and no consensus exists regarding the clinical implications.. Hospital-treated patients above 18 years of age referred for serum cobalamin measurement were included in groups of patients [percentage cobalamin supplemented] with low (<200 pmol/L, n = 200 [6%]), normal (200-600, n = 202 [6%]) high (601-1000, n = 217 [27%]) and very high (>1000, n = 199 [53%]) cobalamin levels. Total and cobalamin-saturated (holo) transcobalamin, total haptocorrin, soluble TC receptor, sCD320, and methylmalonic acid were analyzed. Data on diagnoses and medical prescriptions was obtained through medical files and the Aarhus University Prescription Database.. Among patients not cobalamin supplemented median total haptocorrin and holo transcobalamin levels were markedly higher in the groups with high/very high cobalamin levels compared to groups with low/normal cobalamin levels. Median total transcobalamin and sCD320 levels were similar across the groups. A number of diagnoses were significantly associated to very high Cbl levels (odds ratio (95% confidence interval)): alcoholism (5.74 (2.76-11.96)), liver disease (8.53 (3.59-20.23)), and cancer (5.48 (2.85-10.55)). Elevated haptocorrin levels were seen in patients with alcoholism, cancer, liver-, renal-, autoimmune-, and bronchopulmonary disease. No clinical associations to sCD320 and total and holo transcobalamin levels were found.. In non-supplemented patients, high cobalamin levels were associated to high haptocorrin levels, and several diagnoses, including alcoholism, liver disease and cancer. Our study emphasizes that clinicians should take high serum cobalamin levels into consideration in the diagnostic process.

Topics: Aged; Alcoholism; Antigens, CD; Female; Humans; Liver Diseases; Male; Methylmalonic Acid; Middle Aged; Neoplasms; Receptors, Cell Surface; Transcobalamins; Vitamin B 12

In general practice, vitamin B12 levels are measured when searching an origin for an anemic status (usually megaloblastic anemia), for various neurological disorders (usually polyneuropathy) or for neurocognitive disorders. Although the pathologies associated with vitamin B12 deficiency are well known, hypervitaminemic B12 status is often fortuitous and frequent finding. The aim of this article is to present the disease entities associated with hypervitaminemia B12, the clinical implications of this dysvitaminosis and a practical approach when this laboratory abnormality is found.

Topics: Algorithms; Autoimmune Diseases; Female; Hematologic Diseases; Humans; Liver Diseases; Neoplasms; Pregnancy; Premature Birth; Renal Insufficiency; Vitamin B 12

Cobalamin is released during hepatic cytolysis associated with liver injury. Serum B12 concentration is frequently elevated in patients that receive long-term parenteral nutrition (PN). We hypothesized that serum B12 concentration would become elevated in intestinal failure-associated liver disease and would reflect in disease severity.. We retrospectively evaluated 13 patients with short bowel syndrome (<200 cm residual small intestine) that included complete terminal ileum resection (3 male and 10 female, aged 42 to 78 y) that had received parenteral nutrition (PN) 6.1+/-3 years. All 13 patients had received at least 1 liver biopsy for presumed intestinal failure-associated liver disease. At the time of biopsy, patients had received PN between 2 and 7 days a week (4.7+/-1.9 d). The liver biopsies were evaluated and prospectively scored for pathology using 3 independent scoring systems validated for nonalcoholic steatohepatitis and nonalcoholic fatty liver disease [Brunt, NAFLD activity score (NAS) and Dixon methods], whereby numeric values were assigned to degrees of steatosis, inflammation, and fibrosis. Serum B12 concentration and hepatic chemistries (aspartate transaminase, alanine transaminase, alkaline phosphatase, and bilirubin) were recorded within 1 week of the biopsies.. Thirteen biopsies were available for analysis. Serum B12 concentration and hepatic chemistries were available for all biopsy times. The mean serum B12 concentration was 619+/-222 pg/mL. The mean daily parenteral B12 dose was 3.3+/-1.3 mcg. Mean NAS, Brunt, and Dixon scores were 2, 1, and 1, respectively. The Spearman correlation coefficients between serum B12 concentration and liver biopsy scores were 0.15, 0.1, and 0.1 for the NAS, Brunt, and Dixon scores, respectively, indicating that there was no correlation between serum B12 concentration and liver pathology. The Spearman correlation coefficient between the NAS inflammation subscore and serum B12 concentration was 0.02. B12 concentration also failed to correlate with hepatic chemistries. There was surprisingly little correlation between serum B12 concentration and exogenous B12 daily dose through PN (r=0.19, P=0.45).. Elevated serum B12 concentration is commonly encountered in patients who receive long-term parenteral nutrition. This does not seem to be an indicator of hepatic pathology; rather it may reflect the provision of excessive intravenous vitamin B12 and other as yet unknown factors.

Topics: Adult; Aged; Biomarkers; Biopsy; Female; Humans; Ileum; Liver Diseases; Male; Middle Aged; Parenteral Nutrition; Retrospective Studies; Severity of Illness Index; Short Bowel Syndrome; Statistics, Nonparametric; Vitamin B 12; Vitamin B Complex

Alcohol abuse is a major cause of liver cirrhosis as well as chronic liver disease. The aim of the present study was to investigate the possible correlation, between liver dysfunction biological markers and vitamin B12, with interleukin-6, in the serum of alcohol-dependent individuals without liver disease (AWLD). In a sample of 43 alcohol abusing/dependent subjects (33 males and 10 females) treated on an inpatient basis according to a standard detoxification protocol, the serum activities of the hepatic enzymes (ASAT, ALAT, gamma-GT), as well as the concentration of B12 and IL-6, were determined on admission. A strong positive correlation has been observed between IL-6 and B12, ASAT, ALAT, and gamma-GT at the beginning of the detoxification period. The results confirmed that in alcohol-dependent individuals, the median serum concentration of IL-6, before the beginning of the treatment, had a significant positive correlation with the liver dysfunction biological markers and B12. In conclusion, IL-6 might be used as an additional diagnostic marker for the degree of liver dysfunction in alcohol dependent individuals.

Topics: Alanine Transaminase; Alcoholism; Aspartate Aminotransferases; Biomarkers; Female; gamma-Glutamyltransferase; Humans; Interleukin-6; Liver; Liver Diseases; Male; Middle Aged; Vitamin B 12

Homocysteine metabolism may be impaired in chronic liver disease, possibly contributing to fibrogenesis and disease complications.. The goal was to investigate the prevalence and determinants of basal and postprandial hyperhomocysteinemia in patients with chronic liver disease and after orthotopic liver transplantation (OLT).. This was a cross-sectional study of 323 patients with chronic liver disease (93 with hepatitis, 8 with fatty liver, 168 with cirrhosis, and 54 after OLT) and 25 healthy control subjects. Portohepatovenous gradients of total homocysteine (tHcy) and methionine and postload methionine and tHcy kinetics before and after 10 d of supplementation with folate plus vitamin B-6 were investigated in subgroups.. Basal hyperhomocysteinemia was observed in all patient groups (34% of patients with hepatitis, 50% with fatty liver, 54% with cirrhosis, and 52% after OLT). It was more frequently seen in patients with elevated plasma creatinine concentrations and at advanced stages of liver disease. Mean plasma folate was normal in patients with liver disease, but vitamin B-12 was elevated in cirrhosis and vitamin B-6 was low after OLT. There were significant negative associations between tHcy and folic acid or vitamin B-12 concentrations in control subjects and in patients with hepatitis and after OLT. No systematic association between portohepatovenous differences in tHcy and methionine concentrations was found. Cirrhosis was accompanied by impaired methionine clearance. After vitamin supplementation, the area under the tHcy curve improved in cirrhosis at nearly unchanged basal tHcy concentrations.. Basal hyperhomocysteinemia is seen in approximately 50% of patients with cirrhosis and after OLT. Basal tHcy concentrations do not change significantly after supplementation with folate and vitamin B-6, but postprandial Hcy metabolism improves.

Topics: Adult; Area Under Curve; Case-Control Studies; Chronic Disease; Creatinine; Cross-Sectional Studies; Female; Folic Acid; Homocysteine; Humans; Hyperhomocysteinemia; Liver Diseases; Liver Transplantation; Male; Metabolic Clearance Rate; Methionine; Middle Aged; Vitamin B 12; Vitamin B 6

Elevated levels of serum cobalamin may be a sign of a serious, even life-threatening, disease. Diseases such as chronic myeloid leukaemia, promyelocytic leukaemia, polycythaemia vera and hypereosinophilic syndrome are often accompanied by markedly elevated levels of cobalamin in the blood. A rise in the serum cobalamin concentration is one of the diagnostic criteria for polycythaemia vera and hypereosinophilic syndrome. In haematological disorders, the increase in circulating cobalamin levels is predominantly caused by enhanced production of haptocorrin. Several liver diseases such as acute hepatitis, cirrhosis of the liver, hepatocellular carcinoma and metastatic liver disease can also be accompanied by an increase in circulating cobalamin. In liver diseases, the increase in cobalamin is predominantly caused by cobalamin release during hepatic cytolysis and/or through decreased clearance of circulating cobalamin by the affected liver. Liver disorders are not an indication for determining the serum cobalamin concentration. However, a coincidentally observed elevated serum cobalamin concentration is reason for further investigation.

Topics: Hematologic Diseases; Humans; Leukemia; Liver Diseases; Transcobalamins; Vitamin B 12

Elevation of mean cell volume (MCV) is a common clinical problem, but the etiologic spectrum and optimal diagnostic evaluation of macrocytosis are not well defined.. We studied 300 consecutive hospitalized adult patients with MCV values > or = 100 fL. Assessment included complete blood counts, morphologic review, liver function tests, and levels of serum cobalamin (Cbl), methylmalonic acid, and total homocysteine.. The most common cause of macrocytosis was drug therapy, followed by alcohol, liver disease, and reticulocytosis. Megaloblastic hematopoiesis accounted for less than 10% of cases. MCV values > 120 fL were usually caused by Cbl deficiency. Anisocytosis, macro-ovalocytosis, and teardrop erythrocytes were most prominent in megaloblastic hematopoiesis. Elevated levels of serum methylmalonic acid and total homocysteine were useful in the diagnosis of Cbl deficiency.. Drugs and alcohol are the most common causes of macrocytosis in hospitalized patients in a New York City teaching hospital. We have formulated tentative guidelines for the evaluation of high MCV values in this setting.

Topics: Adult; Aged; Alcohol Drinking; Anemia, Macrocytic; Anemia, Megaloblastic; Bone Marrow Diseases; Diagnosis, Differential; Drug-Related Side Effects and Adverse Reactions; Female; Folic Acid; Folic Acid Deficiency; Homocysteine; Humans; L-Lactate Dehydrogenase; Leukocyte Count; Liver Diseases; Liver Diseases, Alcoholic; Male; Methylmalonic Acid; Middle Aged; Platelet Count; Predictive Value of Tests; Prospective Studies; Reticulocyte Count; Sensitivity and Specificity; Vitamin B 12; Vitamin B 12 Deficiency

The effect of cobalt supplementation on serum vitamin B12, growth rate and survival rate was measured in controlled field experiments with Texel twin lambs of the same sex, grazing cobalt-deficient pastures. The non-supplemented lambs had lower serum vitamin B12 concentrations than their supplemented brothers or sisters. During the experiments more lambs died in the non-supplemented than in the supplemented group. At the end of the experiments supplemented lambs weighed (mean live weight) 7.2, 9.5, and 11.0 kg more than non-supplemented lambs in 1991, 1992, and 1993, respectively. Sex-related differences in weight gain and survival rate were observed.

Topics: Animals; Body Weight; Cobalt; Female; Liver Diseases; Male; Netherlands; Sex Characteristics; Sheep; Sheep Diseases; Survival Rate; Vitamin B 12; Vitamin B 12 Deficiency; Weight Gain

Many cobalt-deficient sheep develop liver lesions known as ovine "white liver" disease, but the etiology of these changes is controversial. It has been suggested that cofactors are required for development of liver damage in cobalt-deficient sheep. In this study, one group of lambs (n = 5) was fed a diet low in cobalt (4.5 micrograms/kg) while a group of control lambs (n = 4) received the same diet after it had been supplemented with cobalt (1000 micrograms/kg). All cobalt-depleted lambs had reduced growth rate, anorexia, lacrimation, and alopecia, and they eventually became emaciated (mean body weight at end of study: 83% of initial body weight). Plasma concentrations of bilirubin and serum activity of glutamate-oxaloacetate transferase were elevated in these animals, while plasma concentrations of vitamin B12 were reduced (less than 220 pmol/L from day 42). Fatty degeneration of the liver associated with reduced concentrations of vitamin B12 (14.5 pmol/g) was seen in these animals at necropsy at 196 days. Microscopic liver lesions included accumulation of lipid droplets and lipofuscin particles in hepatocytes, dissociation and necrosis of hepatocytes, and sparse infiltration by neutrophils, macrophages, and lymphocytes. Ultrastructural hepatocytic alterations included swelling, condensation and proliferation of mitochondria, hypertrophy of smooth endoplasmic reticulum, vesiculation and loss of arrays of rough endoplasmic reticulum, and accumulation of lipid droplets and lipofuscin granules in cytoplasm of hepatocytes. No liver lesions were seen in control lambs. The results of this study indicate that cofactors are not a prerequisite to development of hepatic damage in cobalt-deficient sheep. Reduced activities of the vitamin B12-dependent enzymes, methylmalonyl CoA mutase and methionine synthase, and lipid peroxidation are of likely pathogenetic importance in the development of the lesions.

Topics: 5-Methyltetrahydrofolate-Homocysteine S-Methyltransferase; Alopecia; Animals; Anorexia; Aspartate Aminotransferases; Bilirubin; Cobalt; Diet; Disease Models, Animal; Endoplasmic Reticulum, Smooth; gamma-Glutamyltransferase; Liver; Liver Diseases; Methylmalonyl-CoA Mutase; Microscopy, Electron; Sheep; Sheep Diseases; Vitamin B 12

Topics: Animals; Disease Outbreaks; England; Female; Liver Diseases; Sheep; Sheep Diseases; Vitamin B 12

On purpose to study the radioassay of serum vitamin B12 and folic acid using non boil methods in with these two vitamins were released from their endogenous binding proteins with alkaline denaturation and separated the bound vitamins from the free ones with the magnetic iron particles coated these vitamin binders (purified hog intrinsic factor and beta-lactoglobulin from cow milk) were evaluated on precision and accuracy, compared with boil radioassay. 1. The reproducibilities of non boil method were 4.5 +/- 2.5% on vit. B12 and 3.5 +/- 0.2% on folate (n = 10), respectively. 2. The recovery test of the two serum vitamins with the use of cyanocobalamin and pteroylglutamic acid (J.P.) were finely showed the rations of 95.2-99.0% for vit. B12 and 101.0-108.0% for folic acid. And that of folic acid use of 5-methyl-tetrahydro-pteroylglutamic acid was showed the ratios of 101.0-104.0%. The values of folic acid measured by this method were found slightly higher than non boil method using conventional standard. 3. The correlation coefficient between non boil method and boil method were 0.987 and regression equation was showed y = 0.97x + 73.59 for vit. B12 (n = 75) and r = 0.932, y = 1.02x-0.08 (n = 78) for folic acid. 4. Normal range of serum total vit. B12 concentration was 210-920 (484 +/- 160 pg/ml, n = 259) and that of folic acid was 2.5-9.2 (5.2 +/- 1.4 ng/ml, n = 257), as well as boil method. 5. Accordingly it was considered that non boil (new standard) method was excellent for estimation of vitamin B12 and folic acid clinical status.

Topics: Female; Folic Acid; Hematologic Diseases; Humans; Liver Diseases; Male; Radioligand Assay; Reference Values; 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

Blood serum free vitamin B12, bilirubin, alanine aminotransferase levels were measured and thymol test made in 168 patients with viral hepatitis A, 13 with chronic hepatitis, 8 with mechanical jaundice of neoplastic origin, 7 with calculous cholecystitis, and 8 with functional hyperbilirubinemia by the microbiologic methods. Elevated blood serum levels of free vitamin B12, conforming to the disease severity and stage, were revealed in the patients with viral hepatitis A, chronic active hepatitis, and mechanical jaundice of a neoplastic origin with liver involvement. Correlations between cobalaminemia and other functional liver tests were observed. Therefore blood serum vitamin B12 measurements may be used for the assessment of the disease activity and severity of liver parenchyma injury.

Topics: Adolescent; Adult; Humans; Liver; Liver Diseases; Middle Aged; Vitamin B 12

At pasture outlet, mean plasma vitamin B12 varied between 210 and 1,200 pmol/l in 1 month old lambs, 19% of them had values below 250 pmol/l. In those put on OWLD pastures, mean values dropped after 2-4 weeks, and mostly stayed below 150 pmol/l throughout grazing. Plasma methylmalonic acid (MMA) rose above 5 mumol/l 2-8 weeks after outlet, and above 15 mumol/l 4 weeks later. Reduced growth occurred 3-8 weeks after plasma B12 dropped below 150 pmol/l, and 4-6 weeks after MMA rose above 5 mumol/l. Clinical OWLD was most often associated with plasma B12 less than 150 pmol/l and MMA greater than 15 mumol/l. Cobalt fertilization of pastures induced satisfactory plasma B12/MMA values for 3 succeeding years. Elevated plasma B12 was found 3 weeks after Co pellet dosing. The use of Co lick resulted in large individual variations in plasma B12/MMA. The control lambs, which were healthy and grew well on pastures which some years contained marginal/deficient cobalt, had plasma B12/MMA values which varied considerably. One year values indicated functional Co deficiency, but none developed OWLD, and growth was satisfactory, but less than other years. In these lambs, high MMA was not always associated with low B12, or depressed growth. OWLD occurred in Co/B12 deficient lambs, but Co/B12 deficient lambs on other pastures did not develop OWLD.

Topics: Animals; Cobalt; Liver Diseases; Methylmalonic Acid; Sheep; Sheep Diseases; Vitamin B 12

In a flock of thirty lambs ten animals showed symptoms of photosensitisation within a short period of time. Soon after treatment with vitamin B12 the symptoms disappeared. Clinical examination, differential diagnosis, treatment and course of the disease are discussed. It is assumed that the lambs suffered from 'white liver disease'.

Topics: Animals; Cobalt; Deficiency Diseases; Diagnosis, Differential; Liver Diseases; Photosensitivity Disorders; Sheep; Sheep Diseases; Vitamin B 12

During 6 years, altogether 458 twin lambs of the Dala and Rygia breeds with their dams were put on ovine white-liver disease (OWLD) pastures which were moderately, heavily or not cobalt fertilized, or on control pastures 15 km apart. Groups of lambs were untreated, regularly dosed with Co sulphate or vitamin B12, dosed with Co pellets, copper oxide needles (CuO), selenium pellets or Co-Se-Cu glass boli, or had access to Co enriched salt lick. Clinical symptoms in untreated lambs included varying degree of reduced weight gain or loss of weight appearing after 6-12 weeks on pasture, at an age of 10-15 weeks. Additional symptoms were seen 2-4 weeks later, including inappetence, listlessness, and often serous eye discharge and crusty ears. Of the untreated lambs on OWLD pastures 18% died or were eutanized because of OWLD. The condition was preventable by Co or B12 administration, which yielded an average increase of mid Sept. live weights of between 8 and 17 kg. Co fertilization of pastures, use of Co enriched salt lick, or dosing with Co pellets are recommended under practical circumstances. The lambs grazing control pastures were on average 17 kg heavier by mid Sept. than the OWLD lambs. They showed some weight increase on extra Co supply.

Topics: Animals; Cobalt; Female; Liver Diseases; Male; Norway; Sheep; Sheep Diseases; Vitamin B 12; Vitamin B 12 Deficiency

Among factors causing the hepatopath's relative erythrocyte macrocytosis, the influence of alcohol and liver function damage was compared. Hepatopathic macrocytosis is different from Biermer's macrocytosis and evidently involves different pathogenetic mechanisms. It is significant that a deficit in vit. B12 does not occur and a modest deficit in folates only rarely. There is much evidence of an alteration in lipidemia and particularly in apo-protein content. It is concluded that the two factors considered have different mechanisms but produce the same results.

Topics: Anemia, Macrocytic; Female; Humans; Lipid Metabolism; Liver Diseases; Liver Diseases, Alcoholic; Male; Vitamin B 12

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Chronic Disease; Folic Acid; Humans; Liver Diseases; Middle Aged; Radioimmunoassay; Vitamin B 12

Our information about cobalamin transport in the blood is largely based on studies of unsaturated cobalamin-binding proteins. Therefore, the distribution of endogenous cobalamin among these proteins was examined. Normally, R binder (transcobalamin I) carries most of the cobalamin circulating at any given moment, but the proportion varies greatly. Transcobalamin II carries a larger fraction of the cobalamin present in portal vein blood than in hepatic and axillary vein blood. In disease, transcobalamin II occasionally holds the bulk of the vitamin present in peripheral blood. Such was observed in three patients showing quantitative changes of unsaturated binder (either diminished R binder or increased transcobalamin II), but in two cases of chronic liver disease this was independent of unsaturated transcobalamin levels. Four patients with low serum cobalamin levels maintained normal distribution, indicating proportional cobalamin depletion from both binder pools. Small amounts of vitamin were attached in many sera to minor binders, and occasionally seemed to circulate free. These results demonstrate that assumptions that cobalamin is always attached largely to transcobalamin I are not warranted. Cobalamin distribution appears to be governed by many factors, of which the amounts of the binding proteins is only one.

Topics: Axillary Vein; Health Status; Hematologic Diseases; Hepatic Veins; Humans; Liver Diseases; Multiple Myeloma; Myeloproliferative Disorders; Portal Vein; Transcobalamins; Vitamin B 12

Topics: Binding, Competitive; Cobalt Radioisotopes; Erythrocytes; Evaluation Studies as Topic; Folic Acid; Hematologic Diseases; Humans; Iodine Radioisotopes; Liver Diseases; Radioligand Assay; Reagent Kits, Diagnostic; Vitamin B 12

Outbreaks of ovine white liver disease (WLD) on 7 farms in eastern Victoria were investigated. Most occurred in late spring and mainly affected lambs 3 to 6 months old, with a morbidity of 20 to 100% and mortality of 8 to 15%. Clinically affected lambs showed illthrift, emaciation and bilateral, serous, ocular discharge. Clinical pathology showed mild anaemia, elevated serum liver enzymes (GGT, OCT, AST) and low levels of serum vitamin B12. Grossly, the livers were pale, fatty and friable; microscopically there was parenchymal fatty change, bile duct proliferation and ceroid pigmentation. Liver cobalt values were consistently low (mean 0.4 +/- 0.4 mumol/kg D.W.). Levels of cobalt in pasture from 2 properties were very low (0.34 mumol/kg D.W.) The diagnosis of white liver disease was made on the basis of clinical features, specific liver pathology and low cobalt status. Treatment trials established that cobalt injections or oral bullet administration resulted in clinical improvement, significant weight gains, and improved serum vitamin B12 levels. WLD did not recur in previously affected sheep using these treatments. However, when blocks containing cobalt were available continuously, WLD recurred 2 years after the initial outbreak.

Topics: Animals; Australia; Cobalt; Disease Outbreaks; Liver Diseases; Sheep; Sheep Diseases; Vitamin B 12

Blood vitamin status (B1, B2, B6, folic acid and B12) was assessed in 41 patients (M = 39; F = 2) with alcoholic liver disease. Biochemical evidence of thiamine deficiency was observed in all groups of patients. Deficiency of riboflavin was detected in patients with histologically normal liver but not in other groups. All the groups were found to be deficient in pyridoxal-5-phosphate--the active form of vitamin B6 (pyridoxine). Serum folate was decreased in all groups except in those with alcoholic hepatitis: red cell folate was, of course within normal limits in all the groups. Vitamin B12 levels were within normal limits in all groups except the cirrhotic one where it was raised. Clinico-biochemical implications of the findings are discussed. Biochemical changes in blood vitamin status may precede clinical manifestations of a disease process and may have prognostic value.

Topics: Adult; Alcoholism; Folic Acid; Hepatitis; Humans; Liver Cirrhosis, Alcoholic; Liver Diseases; Middle Aged; Pyridoxal Phosphate; Pyridoxine; Riboflavin; Thiamine; Vitamin B 12; Vitamin B Complex

This report describes the results of a vitamin B12 study among ninety normal healthy school children using commercial radioisotopic dilution assay kits. Values obtained in this study are higher than those obtained in previous study by the microbiological assay using L. leichmannii as the test organism. These high values render the commercial kit unsuitable in its present form in the diagnostic process of liver and related diseases where serum vitamin B12 are significantly elevated. Some dilution of the serum will be essential if the commercial kits are to prove useful among populations with normal high vitamin B12 concentrations.

Topics: Biological Assay; Child; Female; Humans; Liver Diseases; Male; Nigeria; Radioisotope Dilution Technique; Reagent Kits, Diagnostic; Vitamin B 12

Abnormalities in some transcobalamin unsaturated binding capacities (TC-UBBC) were found in some patients with treated pernicious anemia who had elevated TC II-UBBC, R-UBBC, and total UBBC, in gastrectomized patients with latent vitamin B12 deficiency who had elevated R-UBBC and UBBC, and in patients with obstructive jaundice who had elevated TC II-UBBC and UBBC. No abnormalities were found in patients who had untreated pernicious anemia, folate deficiency, unclassifiable megaloblastic anemia, tobacco amblyopia, or low serum B12 level but normal capacity to absorb vitamin B12.

Topics: Anemia, Pernicious; Biliary Tract Diseases; Blood Proteins; Female; Humans; Liver Diseases; Male; Sex Factors; Transcobalamins; Vitamin B 12; Vitamin B 12 Deficiency

An outbreak of white liver disease in lambs in Western Australia is described. The disease affected 2- to 3-month-old lambs and was characterised by liver damage, severe ill-thrift, depression, serous ocular discharge, photosensitization, and a high mortality rate. Transient central nervous system signs occurred. A positive response to vitamin B12 therapy was demonstrated.

Topics: Animals; Animals, Newborn; Cobalt; Hepatic Encephalopathy; Liver Diseases; Seasons; Sheep; Sheep Diseases; Vitamin B 12; Vitamin B 12 Deficiency

Twenty-one female patients studied between six and 12 months following a jejunoileal bypass procedure for obesity were found to have a wide variety of metabolic disturbances. Hepatic histological abnormalities were common and included liver cell necrosis and inflammation in nine patients and hepatic fibrosis in five. Liver function tests were no guide to the degree of hepatic impairment. Vitamin B12 malabsorption occurred in seven patients, in six probably as a result of bacterial intestinal overgrowth; three of these six patients had the most serious hepatic morphological changes. Malabsorption rather than poor oral intake of food appeared to account for continued postoperative weight loss in the majority of patients.

Topics: Adolescent; Adult; Female; Humans; Ileum; Jejunum; Liver; Liver Diseases; Malabsorption Syndromes; Middle Aged; Necrosis; Obesity; Vitamin B 12

Topics: Adult; Aged; Alanine Transaminase; Aspartate Aminotransferases; Choline; Dehydrocholic Acid; Drug Combinations; Fatty Liver; Female; Hepatitis; Humans; Liver Cirrhosis; Liver Diseases; Male; Middle Aged; Orotic Acid; Vitamin B 12

Topics: Antipsychotic Agents; Butyrophenones; Chemical and Drug Induced Liver Injury; Drug Therapy, Combination; Female; Humans; Liver Diseases; Liver Extracts; Male; Mental Disorders; Phenothiazines; Uridine Diphosphate Glucose; Uridine Diphosphate Sugars; 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: Adult; Aged; Alcoholism; Female; Glucose; Humans; Liver Diseases; Liver Extracts; Male; Middle Aged; Nucleosides; Vitamin B 12

Serum vitamin B12 and vitamin B12 binding proteins (transcobalamins, TCS) were determined in patients with malaria, amoebic liver abscess, carcinoma of the liver, infectious hepatitis, cirrhosis and chronic myelocytic leukemia (CML) as well as in 60 blood donor subjects. Serum vitamin B12 in patients with infectious hepatitis, cirrhosis and CML were higher than that of the normal subjects. The values of unsaturated vitamin B12 binding capacity (UBBC) in patients with carcinoma of the liver, infectious hepatitis, cirrhosis were lower while that of patients with CML were higher than that of the normal subjects. A markedly increased TCI and decreased TCII was observed in patients with CML while these changes was much less in patients with other liver diseases. The difference was possibly due to a flooding of vitamin B12 from damaged liver cells into the circulation and the decreased synthesis of transcobalamins in patients with liver diseases while the increased granulocytes, the source of TCI, was much increased in patients with CML.

Topics: Carrier Proteins; Humans; Liver; Liver Cirrhosis; Liver Diseases; Transcobalamins; Vitamin B 12

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

Topics: Adrenal Cortex Hormones; Chronic Disease; Hepatitis; Humans; Liver Cirrhosis; Liver Diseases; Phenobarbital; Spironolactone; Vitamin B 12

Topics: Adult; Choline; Dehydrocholic Acid; Drug Combinations; Female; Humans; Liver Diseases; Magnesium; Male; Middle Aged; Orotic Acid; Vitamin B 12

Topics: Adult; Aged; Blood Proteins; Chronic Disease; Humans; Liver Diseases; Middle Aged; 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: Adult; Cholagogues and Choleretics; Choline; Dehydrocholic Acid; Drug Combinations; Drug Evaluation; Female; Humans; Internal Medicine; Liver Diseases; Male; Middle Aged; Orotic Acid; Vitamin B 12

Topics: Carcinoma, Hepatocellular; Female; Humans; Liver Diseases; Liver Neoplasms; Male; Pregnancy; Transcobalamins; Vitamin B 12

Serum vitamin B12 levels were assayed in 25 healthy and 35 protein-malnourished children aged 1-6 years. Serum proteins and haematocrit values of the children were also measured. Liver enlargement was estimated clinically. The mean serum vitamin B12 activity among protein-malnourished children was slightly higher than that for the control group. Serum vitamin B12 activity of the healthy Nigerian children was, however, high, and possible reasons for this are discussed in detail. There was some correlation between very high serum vitamin B12 levels among the protein-malnourished children and incidence of liver enlargement.

Topics: Blood Proteins; Child; Child, Preschool; Hematocrit; Humans; Infant; Liver Diseases; Protein Deficiency; Vitamin B 12

Toxepasi Complex (UDPG, glutathione and vitamin B12) was administered to patients with aggressive chronic hepatitis and a second group with severe cirrhosis. Changes in laboratory enzymological data indicative of the overall extent of liver damage due to cell necrosis, cholostasis and impairment of protein synthesis were evaluated. Decreases tending to normalisation were noted two weeks after the commencement of treatment, particularly in the first group. The results suggest that the complex may be usefully employed in the management of aggressive chronic hepatitis and cirrhosis of the liver.

Topics: Adolescent; Adult; Aged; Blood Protein Electrophoresis; Drug Combinations; Female; Glutathione; Hepatitis; Humans; Immunoglobulins; Liver Cirrhosis; Liver Diseases; Male; Middle Aged; Oxidoreductases; Transaminases; Uridine Diphosphate Glucose; Uridine Diphosphate Sugars; Vitamin B 12

Topics: Hepatitis A; Humans; Liver Cirrhosis; Liver Diseases; Malabsorption Syndromes; Vitamin B 12

Topics: Adult; Aged; Alcohol Amnestic Disorder; Alcoholism; Alkaline Phosphatase; Aspartate Aminotransferases; Biological Assay; Epilepsy; Euglena gracilis; Female; Folic Acid; Folic Acid Deficiency; Hematocrit; Hemoglobins; Humans; Lacticaseibacillus casei; Liver Diseases; Male; Middle Aged; Pyridoxal; Vitamin B 12

Topics: Adenosine; Adrenal Glands; Adult; Aged; Asthenia; Cytidine; Drug Combinations; Female; Guanosine; Hepatitis A; Humans; Liver; Liver Diseases; Liver Extracts; Liver Function Tests; Male; Middle Aged; Nucleosides; Tissue Extracts; Uridine; Vitamin B 12

Topics: Diet Therapy; Dietary Fats; Dietary Proteins; Humans; Liver Diseases; 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: Alcoholism; Anemia, Macrocytic; Electronics, Medical; Erythrocytes; Folic Acid; Folic Acid Deficiency; Humans; Liver Diseases; Male; Middle Aged; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Chronic Disease; Fatty Liver; Hepatitis; Humans; Intestinal Absorption; Liver Cirrhosis; Liver Diseases; Liver Neoplasms; Radioimmunoassay; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Adenine; Adult; Child; Drug Combinations; Folic Acid; Hepatitis A; Humans; Hydroxocobalamin; Inosine; Liver Diseases; Methionine; Middle Aged; Niacinamide; Nucleosides; Riboflavin; Vitamin B 12

Topics: Adult; Aged; Anorexia Nervosa; Cobamides; Coenzymes; Drug Combinations; Evaluation Studies as Topic; Feeding and Eating Disorders; Female; Humans; Liver Diseases; Male; Middle Aged; Polyneuropathies; Pyridoxal Phosphate; Thiamine; Thiamine Pyrophosphate; Vitamin B 12

Topics: Administration, Oral; Cholagogues and Choleretics; Ethanol; Evaluation Studies as Topic; Humans; Liver Diseases; Pyrans; Vitamin B 12

Topics: Alcoholism; Cholelithiasis; Choline; Diabetes Complications; Drug Combinations; Homocysteine; Humans; Lactones; Liver Diseases; Phosphoric Acids; Vitamin B 12

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: Acute Disease; Adult; Aged; Alanine Transaminase; Alkaline Phosphatase; Amino Acids; Aspartate Aminotransferases; Bilirubin; Body Weight; Chronic Disease; Citric Acid Cycle; Drug Combinations; Evaluation Studies as Topic; Female; Humans; Liver Diseases; Liver Extracts; Male; Middle Aged; Vitamin B 12

Topics: Cobalt Isotopes; Gold Colloid, Radioactive; Humans; Iodine Radioisotopes; Liver; Liver Cirrhosis; Liver Diseases; Liver Neoplasms; Methods; Radioisotope Dilution Technique; Radionuclide Imaging; Rose Bengal; Vitamin B 12

Topics: Blood Protein Disorders; Child, Preschool; Deficiency Diseases; Female; Humans; Hypoproteinemia; Infant; Infant, Newborn; Liver Diseases; Liver Extracts; Male; Nucleosides; Uridine; Vitamin B 12

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

Topics: Adult; Aged; Female; Folic Acid; Humans; Liver Diseases; Male; Mannitol; Middle Aged; Vitamin B 12

Intestinal function was studied in 26 patients with seven types of acute and chronic liver disease, documented by liver biopsy. Steatorrhea, defined by a stool fat higher than 6 g. per day, was present in 18 of 23 consecutive patients studied, an incidence of 78.3%. Two patients with infectious hepatitis associated with steatorrhea studied previously were added and the 20 cases were analyzed. The malabsorption found was confined to fat and fat-soluble vitamins; stool excretion varied from 6.1 to 22 g. per day in the seven groups studied. No histological abnormality was seen on jejunal biopsy, serum vitamin B(12), D-xylose and Schilling tests were normal, and no radiological findings associated with malabsorption were detected in the small bowel. It is concluded that steatorrhea is a common finding in a wide variety of acute and chronic liver diseases and cannot be attributed to a primary defect of the small bowel.

Topics: Acute Disease; Adolescent; Adult; Alkaline Phosphatase; Aspartate Aminotransferases; Bilirubin; Celiac Disease; Chromatography, Thin Layer; Chronic Disease; Diagnosis, Differential; Female; Hepatitis A; Humans; Intestinal Absorption; Intestine, Small; Liver Diseases; Liver Function Tests; Malabsorption Syndromes; Male; Middle Aged; Pancreatitis; 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; Aged; Anemia, Pernicious; Autoradiography; Chromatography, Thin Layer; Diet, Vegetarian; Female; Folic Acid Deficiency; Humans; Hydroxocobalamin; Intestinal Diseases; Leukemia; Liver; Liver Cirrhosis; Liver Diseases; Male; Middle Aged; Postgastrectomy Syndromes; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Adolescent; Adult; Aged; Female; Humans; Liver Diseases; Liver Extracts; Male; Middle Aged; Nucleosides; Pyrimidines; Uridine; Vitamin B 12

Topics: Adolescent; Adult; Anemia, Macrocytic; Atrophy; Biopsy; Bone Marrow Cells; Child; Cobalt Isotopes; Diarrhea; Edema; Female; Folic Acid; Folic Acid Deficiency; Humans; Intestinal Absorption; Intestinal Mucosa; Jejunum; Liver Diseases; Malabsorption Syndromes; Male; Middle Aged; Protein Deficiency; Serum Albumin; Vitamin B 12; Vitamin B 12 Deficiency

A syndrome of choreoathetosis in association with alcoholism has been found in 12 patients. It appeared to occur more often in women, was transient, and may have been associated with alcohol withdrawal. It was not associated with gross liver disease, phenothiazine administration, or familial chorea, and no consistent abnormalities in whole blood thiamine or nicotinic acid, in serum magnesium, or in serum vitamin B(12) levels were present.

Topics: Adult; Aged; Alcoholism; Athetosis; Chorea; Female; Humans; Huntington Disease; Liver Diseases; Magnesium; Male; Middle Aged; Nicotinic Acids; Phenothiazines; Sex Factors; Substance Withdrawal Syndrome; Thiamine; Vitamin B 12

Topics: Administration, Oral; Blood Glucose; Chromatography, Thin Layer; Citrates; Diabetes Mellitus; Fatty Acids, Nonesterified; Female; Hepatitis; Humans; Ketoglutaric Acids; Lactates; Liver Cirrhosis; Liver Diseases; Malonates; Middle Aged; Pyruvates; Valine; Vitamin B 12

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

Topics: Body Weight; Carbohydrate Metabolism; Colon; Diarrhea; Digestive System Surgical Procedures; Electrolytes; Female; Humans; Hypertension; Ileum; Jejunum; Lipid Metabolism; Liver Diseases; Malabsorption Syndromes; Male; Methods; Obesity; Postoperative Complications; Preoperative Care; Proteins; Prothrombin; Stomach; Vitamin B 12

Topics: Adrenal Cortex Hormones; Anabolic Agents; Chronic Disease; Hepatitis; Humans; Liver Cirrhosis; Liver Diseases; Prednisolone; Thiamine; Vitamin B 12; Vitamin B Complex

Topics: Acute Disease; Chronic Disease; Coenzymes; Folic Acid; Hepatitis; Histidine; Humans; Liver Cirrhosis; Liver Diseases; Liver Function Tests; Liver Neoplasms; Male; Middle Aged; Vitamin B 12

Topics: Blood Cell Count; Bone Marrow; Chronic Disease; Hematopoiesis; Humans; Liver; Liver Diseases; Liver Extracts; Liver Function Tests; Nucleosides; Vitamin B 12

Topics: Alcoholism; Humans; Liver Diseases; Liver Extracts; Liver Function Tests; Nucleosides; Pyrimidines; Sulfobromophthalein; Vitamin B 12

Topics: Adult; Aged; Alcoholism; Female; Folic Acid; Humans; Liver Diseases; Liver Function Tests; Male; Mental Disorders; Middle Aged; Neurocognitive Disorders; Nutritional Physiological Phenomena; Vitamin B 12

Topics: Anabolic Agents; Body Weight; Calorimetry; Chronic Disease; Depression, Chemical; Diet Therapy; Feces; Food Analysis; Humans; Liver Cirrhosis; Liver Diseases; Nitrogen; Prednisone; Proteins; Pyridoxine; Vitamin B 12

Topics: Blood Coagulation Disorders; Blood Coagulation Factors; Blood Coagulation Tests; Hematologic Diseases; Humans; Iron; Liver Diseases; Vitamin B 12

Topics: Antitubercular Agents; Drug Combinations; Female; Humans; Liver Diseases; Liver Extracts; Male; Middle Aged; Time Factors; Tuberculosis, Pulmonary; Vitamin B 12; Vitamin E; Vitamin K

Topics: Drug Tolerance; Folic Acid; Humans; Liver Diseases; Vitamin B 12

Topics: Albumins; Alpha-Globulins; Beta-Globulins; Blood Proteins; Cobalt Isotopes; Electrophoresis; Humans; Leukemia, Myeloid; Liver Diseases; Protein Binding; Vitamin B 12

Topics: Anemia, Pernicious; Chromatography, Thin Layer; Humans; Leukemia, Myeloid; Liver Diseases; Photometry; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Amides; Liver Diseases; Liver Extracts; Sulfonic Acids; Vitamin B 12

Topics: Chronic Disease; Humans; Liver Diseases; Vitamin B 12; Vitamins

Topics: Acetanilides; Adrenal Glands; Hematoporphyrins; Humans; Liver Diseases; Liver Extracts; Porphyrins; Pyridoxine; Tissue Extracts; Vitamin B 12

Topics: Alcohols; Animals; Biological Assay; Cysteine; Dosage Forms; Injections, Intravenous; Liver Diseases; Liver Extracts; Rats; Vitamin B 12

Topics: Arthritis, Rheumatoid; Coenzymes; Hepatitis; Hepatitis A; Humans; Liver Cirrhosis; Liver Diseases; Liver Extracts; Osteoarthritis; Sciatica; Vitamin B 12

During the active phase of viral hepatitis urinary folate loss was found to be 8.0 to 48.3 (mean 31.1) mug./day, compared with a normal urinary folate excretion of 0.1 to 18.0 (mean 9.5) mug./day. In cirrhosis and cardiac failure with congestive hepatomegaly the corresponding values were 25.8 to 55.0 (mean 35.7) mug./day and 2.5 to 61.6 (mean 26.9) mug./day, respectively. Urinary folate loss may be a significant factor in the aetiology of folate deficiency of chronic liver disease, particularly when dietary intake is poor.After prolonged dialysis in Visking casing urinary folate was almost totally dialysable, but an appreciable fraction of serum folate was not, even after 72 hours. The dialysable (free) folate fraction of serum and urine disappeared maximally during the first six hours' dialysis, and was virtually cleared after 24 hours' dialysis; clearance curves in normal individuals and in liver disease were comparable. The non-dialysable serum folate fraction was of similar magnitude in all subjects studied, in spite of marked variation in total folate, and probably represented protein-bound folate.

Topics: Adult; Biological Assay; Dialysis; Folic Acid; Folic Acid Deficiency; Heart Failure; Humans; Lactobacillus; Liver Diseases; Vitamin B 12

Topics: Blood Proteins; Cachexia; Chronic Disease; Humans; Kidney Diseases; Liver Diseases; Liver Extracts; Neoplasms; Vitamin B 12

Topics: Aged; Alkaline Phosphatase; Aspartate Aminotransferases; Bilirubin; Blood Pressure; Cholesterol; Female; Folic Acid; Hemoglobinometry; Humans; Kidney Diseases; Liver Diseases; Liver Function Tests; Male; Middle Aged; Serum Albumin; Serum Globulins; Urea; Vitamin B 12

Topics: Adult; Amino Acids; Carbon Tetrachloride Poisoning; Cholecystitis; Cholelithiasis; Female; Folic Acid; Humans; Liver Diseases; Liver Function Tests; Male; Middle Aged; Niacinamide; Vitamin B 12

Topics: Adolescent; Adult; Aged; Humans; Leucovorin; Liver Diseases; Methionine; Middle Aged; Niacinamide; Nucleosides; Vitamin B 12

Topics: Aged; Amino Acids; Bilirubin; Female; Folic Acid; Humans; Liver Diseases; Liver Function Tests; Male; Middle Aged; Niacinamide; Transaminases; Vitamin B 12

Topics: Adult; Aged; Animals; Biopsy; Drug Synergism; Female; Folic Acid; Humans; Liver; Liver Diseases; Male; Methionine; Mice; Middle Aged; Niacinamide; Nucleosides; Nucleotides; Rats; Vitamin B 12

Topics: Adolescent; Adult; Aged; Anorexia Nervosa; Blood; Blood Proteins; Body Weight; Cobamides; Coenzymes; Evaluation Studies as Topic; Feeding and Eating Disorders; Female; Gastrointestinal Diseases; Hemoglobinometry; Humans; Liver Diseases; Male; Middle Aged; Neoplasms; Respiratory Tract Diseases; Vitamin B 12

Topics: Aged; Brain Diseases; Electroencephalography; Hepatic Encephalopathy; Humans; Infusions, Parenteral; Liver Diseases; Methods; Middle Aged; Rutin; Vitamin A; Vitamin B 12; Vitamin B Complex

Topics: Cholestasis; Chronic Disease; Fatty Liver; FIGLU Test; Folic Acid; Hepatitis A; Histidine; Humans; Liver Cirrhosis; Liver Diseases; Vitamin B 12

Topics: Folic Acid; Humans; Liver Diseases; 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: Aged; Arteriosclerosis; Cholesterol; Female; Humans; Liver Diseases; Liver Extracts; Liver Function Tests; Male; Nucleosides; Uridine; Vitamin B 12

Topics: Age Factors; Aged; Bilirubin; Female; Humans; Liver Diseases; Liver Extracts; Male; Nucleosides; Uridine; Vitamin B 12

Topics: Adult; Aged; Cholangitis; Female; Humans; Liver Diseases; Liver Extracts; Male; Mannitol; Middle Aged; Nucleosides; Tuberculosis, Pulmonary; Uridine; Vitamin B 12

Topics: Adult; Aged; Arginine; Citrulline; Folic Acid; Humans; Liver Diseases; Middle Aged; Niacinamide; Ornithine; Vitamin B 12

Topics: Adult; Aged; Arginine; Citrulline; Folic Acid; Humans; Liver Diseases; Male; Middle Aged; Niacinamide; Ornithine; Vitamin B 12

Topics: Adolescent; Adult; Aged; Arginine; Biliary Tract Diseases; Citrulline; Female; Folic Acid; Humans; Liver Diseases; Male; Middle Aged; Niacinamide; Ornithine; Vitamin B 12

Topics: Arginine; Citrulline; Female; Folic Acid; Humans; Liver Diseases; Male; Niacinamide; Ornithine; Vitamin B 12

Topics: Adolescent; Adult; Aged; Arginine; Child; Citrulline; Female; Folic Acid; Humans; Liver Diseases; Male; Middle Aged; Niacinamide; Ornithine; Vitamin B 12

Topics: Adolescent; Adult; Aged; Arginine; Citrulline; Female; Folic Acid; Humans; Liver Diseases; Male; Middle Aged; Niacinamide; Ornithine; Vitamin B 12

Topics: Adult; Aged; Arginine; Citrulline; Female; Folic Acid; Humans; Liver Diseases; Male; Middle Aged; Niacinamide; Ornithine; Vitamin B 12

Topics: Adult; Aged; Arginine; Citrulline; Folic Acid; Humans; Liver Diseases; Middle Aged; Niacinamide; Ornithine; Vitamin B 12

Topics: Arginine; Citrulline; Folic Acid; Humans; Liver Diseases; Niacinamide; Ornithine; Vitamin B 12

Topics: Adult; Aged; Amino Acids; Arthritis, Rheumatoid; Biliary Dyskinesia; Dyspepsia; Female; Folic Acid; Gallbladder Diseases; Gastritis; Humans; Liver Diseases; Male; Middle Aged; Niacinamide; Vitamin B 12

Topics: Cholagogues and Choleretics; Chronic Disease; Folic Acid; Humans; Liver Diseases; Liver Extracts; Nicotinic Acids; Vitamin B 12

Topics: Barbiturates; Erythrocytes; Hemolysis; Humans; Hydrochlorothiazide; In Vitro Techniques; Liver Diseases; Osmosis; Prednisone; Sulfisoxazole; Vitamin B 12

Topics: Adolescent; Animals; Child; Child, Preschool; Female; Hematologic Diseases; Humans; Infant; Infections; Kidney Diseases; Lactobacillus; Liver Diseases; Male; Rats; Rheumatic Fever; Vitamin B 12

Topics: Biliary Tract Diseases; Chemical and Drug Induced Liver Injury; Chronic Disease; Fatty Liver; Health Resorts; Hepatitis; Humans; Liver Cirrhosis; Liver Diseases; Vitamin B 12

Topics: Adult; Aged; Amino Acids; Cholelithiasis; Female; Folic Acid; Humans; Liver Diseases; Male; Middle Aged; Niacinamide; Nucleosides; 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: Chronic Disease; Folic Acid; Humans; Liver Diseases; Vitamin B 12

Topics: Animals; Choline; Choline Deficiency; Deficiency Diseases; Kidney Diseases; Liver Diseases; Methionine; Rats; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Adolescent; Adult; Aged; Cholecystitis; Cholelithiasis; Female; Humans; Liver Diseases; Liver Extracts; Male; Middle Aged; Nucleosides; Uridine; 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: Adolescent; Anemia; Ascorbic Acid; Child; Corrinoids; Folic Acid; Geriatrics; Humans; Injections, Intravenous; Liver Diseases; Niacinamide; Syndrome; Vitamin B 12; Vitamin B Complex; Vitamins

Topics: Acne Vulgaris; Humans; Liver Diseases; Liver Extracts; Vitamin B 12

Topics: Female; Humans; Liver Diseases; Liver Extracts; Male; Vitamin B 12

Topics: Adult; Aged; Asthenia; Coenzymes; Deficiency Diseases; Emaciation; Humans; Liver Diseases; Middle Aged; Neoplasms; Respiratory Tract Diseases; 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: Adolescent; Biopsy; Blood Chemical Analysis; Folic Acid; Geriatrics; Lactococcus lactis; Liver; Liver Diseases; Liver Neoplasms; Metabolism; Streptococcus; 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: 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: Aspartic Acid; Humans; Liver Diseases; Liver Extracts; Vitamin B 12; Vitamin B Complex; Yeast, Dried

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: 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, 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: Blood; Chemical and Drug Induced Liver Injury; Chlorpromazine; Cholangitis; Diagnosis; Hepatitis; Hepatitis A; Humans; Jaundice; Jaundice, Obstructive; Liver Cirrhosis; Liver Diseases; Liver Neoplasms; Monoamine Oxidase Inhibitors; Prognosis; Vitamin B 12

Topics: Avitaminosis; Carbon Tetrachloride Poisoning; Chemical and Drug Induced Liver Injury; DNA; Folic Acid; Folic Acid Deficiency; Hepatitis; Liver Diseases; Liver Regeneration; Metabolism; Necrosis; Pharmacology; Rats; Research; Thymidine; Uracil; Vitamin B 12

Topics: Chemical and Drug Induced Liver Injury; Cobalt Isotopes; Hepatitis; Hepatitis A; Humans; Jaundice; Jaundice, Obstructive; Liver Diseases; Liver Function Tests; Toxicology; Vitamin B 12

Topics: Corrinoids; Hematinics; Hepatectomy; Liver Diseases; Liver Regeneration; Oxyphenbutazone; Rats; Testosterone; Vitamin B 12

Topics: Cysteine; Female; Gluconates; Humans; Liver Diseases; Liver Extracts; Menstruation Disturbances; Methionine; Niacin; Niacinamide; Premenstrual Syndrome; Thioctic Acid; Vitamin B 12; Vitamin B Complex

Topics: Alanine Transaminase; Carbon Tetrachloride Poisoning; D-Alanine Transaminase; Hepatectomy; Lipid Metabolism; Liver; Liver Diseases; Liver Regeneration; Rats; Research; Vitamin B 12

Topics: Cysts; Dermatitis, Exfoliative; Dermatology; Drug Eruptions; Eczema; Lead Poisoning; Liver Diseases; Psoriasis; Quinolines; Skin Neoplasms; Toxicology; Vitamin B 12

Topics: Cobalt Isotopes; Heart; Humans; Liver Diseases; Liver Diseases, Parasitic; Metabolism; Radioisotopes; Radionuclide Imaging; Schistosomiasis; Spleen; Vitamin B 12

Topics: Adrenal Cortex Hormones; Amino Acids; Ascorbic Acid; Corrinoids; Diet; Diet Therapy; Folic Acid; Geriatrics; Hematinics; Humans; Liver Diseases; Liver Extracts; Proteins; Rest; Vitamin B 12

Topics: 17-Ketosteroids; Anorexia Nervosa; Cortisone; Endotoxins; Hematinics; Hepatitis; Liver Diseases; Liver Glycogen; Liver Regeneration; Mental Disorders; Stress, Physiological; Toxicology; Vitamin B 12

Topics: Adolescent; Amino Acids; Corrinoids; Humans; Liver Diseases; Methionine; Sulfur; Tuberculosis; Urine; Vitamin B 12

Topics: Carbon Tetrachloride; Hematinics; Liver Diseases; Liver Regeneration; Regeneration; Vitamin B 12

Topics: Ascorbic Acid; Corrinoids; Folic Acid; Liver Diseases; Niacin; Nicotinic Acids; Vitamin B 12; Vitamins

Topics: Corrinoids; Hematinics; Liver Diseases; Vitamin B 12

Topics: Kidney Diseases; Liver Diseases; Liver Extracts; Vitamin B 12

Topics: Animals; Choline; Choline Deficiency; Diet; Fats; Fatty Acids; Kidney; Liver Diseases; Nutrition Assessment; Protein Deficiency; Rats; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Anatomy; Androgens; Animals; Body Weight; Corrinoids; Cortisone; Incidence; Kidney Diseases; Liver Diseases; Mice; Myocardium; Necrosis; Pericarditis; Testosterone; Vitamin B 12

Topics: Diabetes Mellitus; Female; Fetus; Folic Acid; Hematinics; Humans; Hypothyroidism; Liver Diseases; Metabolic Diseases; Pregnancy; Vitamin B 12; Vitamin B Complex; Vitamins

Topics: Animals; Carbon Tetrachloride Poisoning; Chemical and Drug Induced Liver Injury; Hepatitis; Hepatitis A; Iodine Isotopes; Liver Diseases; Liver Function Tests; Vitamin B 12

Topics: Corrinoids; Hematinics; Humans; Liver Diseases; Vitamin B 12

Topics: Corrinoids; Enzymes; Hematinics; Humans; Iron; Liver Diseases; Proteins; Vitamin B 12

Topics: Ascorbic Acid; Carbon Tetrachloride; Chronic Disease; Folic Acid; Humans; Liver Diseases; Niacinamide; Vitamin B 12; Vitamin K; Vitamins

Topics: Animals; Bile; Choline; Corrinoids; Dogs; Hematinics; Liver Diseases; Phospholipids; Vitamin B 12

Topics: Ascorbic Acid; Folic Acid; Humans; Liver Diseases; Niacinamide; Tuberculosis; Vitamin B 12; Vitamin B Complex; Vitamins

Topics: Alkaline Phosphatase; Corrinoids; Hematinics; Liver Diseases; Organic Chemicals; Phosphoric Monoester Hydrolases; Vitamin B 12

Topics: Corrinoids; Hematinics; Liver Diseases; Organic Chemicals; Vitamin B 12; Vitamins

Topics: Coenzyme A; Coenzymes; Corrinoids; Hematinics; Liver Diseases; Liver Extracts; Thioctic Acid; Vitamin B 12; Vitamins

Topics: Blood Proteins; Corrinoids; Hematinics; Lipids; Liver Diseases; Vitamin B 12

Topics: Humans; Liver Diseases; Metabolic Diseases; Vitamin B 12

Topics: Hematinics; Humans; Liver Diseases; Vascular Diseases; Vitamin B 12

Topics: Liver Diseases; Vitamin B 12

Topics: Ascorbic Acid; Corrinoids; Folic Acid; Humans; Liver Diseases; Niacin; Niacinamide; Nicotinic Acids; Proteins; Vitamin B 12; Vitamins

Topics: Corrinoids; Diagnosis, Differential; Hematinics; Humans; Liver Diseases; Prognosis; Vascular Diseases; Vitamin B 12

Topics: Carbon Tetrachloride; Cobalt; Corrinoids; Liver Diseases; Necrosis; Vitamin B 12

Topics: Hematinics; Humans; Liver Diseases; Vascular Diseases; Vitamin B 12

Topics: Corrinoids; Liver; Liver Diseases; Regeneration; Vitamin B 12; Vitamins

Topics: Hematinics; Humans; Leukemia; Leukemia, Myelogenous, Chronic, BCR-ABL Positive; Leukemia, Myeloid; Liver Diseases; Serum; Vitamin B 12

Topics: Corrinoids; Hematinics; Liver Diseases; Organic Chemicals; Vitamin B 12

Topics: Animals; Carbon Tetrachloride; Hematinics; Liver Diseases; Rats; Vitamin B 12

Topics: Animals; Hyperthyroidism; Liver Diseases; Mitochondria; Rats; Thyrotoxicosis; Vitamin B 12; Vitamin B Complex

Topics: Corrinoids; Hematinics; Humans; Liver Diseases; Vitamin B 12

Topics: Humans; Liver Diseases; Metabolic Diseases; Vitamin B 12

Topics: Ascorbic Acid; Child; Corrinoids; Folic Acid; Infant; Liver Diseases; Niacin; Niacinamide; Nicotinic Acids; Vitamin B 12; Vitamins

Topics: Humans; Liver Diseases; Vitamin B 12; Vitamin K; Vitamins

Topics: Heart Failure; Humans; Liver; Liver Diseases; Vitamin B 12; Vitamin B Complex

Topics: Corrinoids; Liver Diseases; Vitamin A; Vitamin B 12; Vitamin K; Vitamins

Topics: Biological Transport; Body Fluids; Hematinics; Humans; Liver Diseases; Vitamin B 12

Topics: Corrinoids; Hematinics; Liver Diseases; Vascular Diseases; Vitamin B 12

Topics: Body Fluids; Hematologic Diseases; Humans; Liver Diseases; Vitamin B 12

Topics: Humans; Leukemia; Leukemia, Myeloid; Liver Diseases; Vitamin B 12

Topics: Diet; Humans; Liver Diseases; Proteins; Vitamin B 12

Topics: Ascorbic Acid; Folic Acid; Humans; Liver Diseases; Niacin; Niacinamide; Nicotinic Acids; Vitamin B 12; Vitamins

Topics: Humans; Liver Diseases; Metabolic Diseases; Vitamin B 12

Topics: Hematinics; Humans; Liver Diseases; Serum; Vascular Diseases; Vitamin B 12

Topics: Corrinoids; Hematinics; Liver; Liver Diseases; Vitamin B 12

Topics: Bile Duct Diseases; Bile Ducts; Humans; Liver Diseases; Vitamin B 12

Topics: Corrinoids; Humans; Liver Diseases; Tuberculosis; Vitamin B 12

Topics: Anemia; Endocrine System Diseases; Eukaryota; Hematologic Diseases; Humans; Leukemia; Liver Diseases; Vitamin B 12

Topics: Corrinoids; Hematinics; Humans; Liver Diseases; Vascular Diseases; Vitamin B 12

Topics: Anemia; Corrinoids; Endocrine System Diseases; Humans; Leukemia; Liver Diseases; Vitamin B 12

Topics: Corrinoids; Hematinics; Humans; Liver Diseases; Vascular Diseases; Vitamin B 12

Topics: Blood Proteins; Liver Diseases; Serum Albumin; Serum Albumin, Human; Serum Globulins; Vitamin B 12

Topics: Corrinoids; Hematinics; Humans; Liver Diseases; Nucleic Acids; Vitamin B 12

Topics: Anemia, Macrocytic; Erythrocytes; Humans; Liver Cirrhosis; Liver Diseases; Liver Extracts; Spleen; Vitamin B 12

Topics: Corrinoids; Humans; Liver Diseases; Vitamin B 12

Topics: Diet; Humans; Liver Diseases; Vitamin B 12

Topics: Animals; Fatty Liver; Ligation; Liver Diseases; Pancreatic Ducts; Rats; Vitamin B 12

Topics: Corrinoids; Hematinics; Humans; Liver Diseases; Riboflavin; Thiamine; Urine; Vitamin B 12; Vitamin B Complex

Topics: Amino Acids; Animals; Corrinoids; Fatty Liver; Glycine; Glycine Agents; Liver Diseases; Rats; Tryptophan; Vitamin B 12

Topics: Blood; Hepatitis; Humans; Liver Cirrhosis; Liver Diseases; Vitamin B 12

Topics: Choline; Fatty Liver; Liver Diseases; Methionine; Vitamin B 12; Vitamin B Complex

Topics: Corrinoids; Liver Diseases; Protective Agents; Vitamin B 12

Topics: Animals; Choline; Diet; Fatty Liver; Lipotropic Agents; Liver Diseases; Methionine; Rats; Vitamin B 12; Zea mays

Topics: Choline; Lipotropic Agents; Liver Diseases; Vitamin B 12

Topics: alpha-Tocopherol; Cryptococcus; Growth; Hispanic or Latino; Liver Diseases; Methionine; Vitamin B 12; Vitamin E

Topics: Corrinoids; Hematinics; Liver; Liver Diseases; Liver Regeneration; Vitamin B 12

Topics: Anemia; Dietetics; Folic Acid; Humans; Liver Diseases; Vitamin B 12

Topics: Corrinoids; Fatigue; Humans; Liver Diseases; Vitamin B 12; Vitamin B Complex

Topics: Folic Acid; Humans; Liver Diseases; Vitamin B 12; Vitamin B Complex

Topics: Animals; Corrinoids; Growth; Liver Diseases; Rats; Vitamin B 12

Topics: Adrenal Glands; Carbon Tetrachloride; Carbon Tetrachloride Poisoning; Corrinoids; Liver Diseases; Tissue Extracts; Vitamin B 12