vitamin-b-12 and Scleroderma--Systemic

Topics: Anemia, Hemolytic; Anemia, Hypochromic; Anemia, Megaloblastic; Arthritis, Juvenile; Arthritis, Rheumatoid; Blood Volume; Collagen Diseases; Dermatomyositis; Felty Syndrome; Folic Acid; Hemolysis; Humans; Hyperplasia; Iron; Lupus Erythematosus, Systemic; Myositis; Polyarteritis Nodosa; Polymyalgia Rheumatica; Scleroderma, Systemic; Vitamin B 12

Topics: Bacteria; Bacteroides; Diabetes Mellitus; Diarrhea; Dietary Carbohydrates; Dietary Fats; Duodenum; Dysentery, Bacillary; Enterobacteriaceae; Escherichia coli; Feces; Gastrointestinal Motility; Humans; Ileum; Intestinal Absorption; Intestinal Diseases; Intestines; Jejunum; Lactobacillus; Postgastrectomy Syndromes; Scleroderma, Systemic; Sprue, Tropical; Stomach; Vibrio; Vitamin B 12; Water-Electrolyte Balance

In patients with systemic sclerosis (SSc) gastrointestinal (GI) involvement, nutritional status and medications may lead to cobalamin (Vit B12) deficiency. We aimed to determine the frequency and the potential causes of Vit B12 deficiency in SSc patients.. We conducted a cross-sectional analysis of 62 SSc patients in a single center in 1 year period. Medical history and physical examination of patients were reevaluated. Data about organ involvements were obtained from hospital file records. The nutritional status of the patients was assessed with Malnutrition Universal Screening Tool (MUST). Vit B12, homocysteine (except in three patients) and Helicobacter Pylori Immunoglobulin G (H. Pylori IgG) levels were measured in all patients. Vit B12 deficiency was considered as serum Vit B12 level <200 pg/mL or being on Vit B12 replacement therapy. Serum Vit B12 levels of the patients were also grouped as low (<200 pg/mL), borderline (200-300 pg/mL) and normal (>300 pg/mL). Plasma homocysteine levels of the patients were classified as elevated (>9 μmol/L) and hyperhomocysteinemia (>15 μmol/L). Mann-Whitney U and Kruskal-Wallis tests were used to compare parameters among the groups. Correlation was tested by Spearman's correlation coefficient.. Forty-four (71.0%) patients were defined as Vit B12 deficient; 22 had Vit B12 level <200 pg/mL (four were on Vit B12 replacement therapy) and the remaining 22 had Vit B12 >200 pg/mL and were already on Vit B12 replacement therapy. The percentage of the patients with hyperhomocysteinemia was significantly higher in the group with Vit B12 <200 pg/mL as compared to other groups (P = 0.004) but only 33.3% (7/21) of the patients with Vit B12 <200 pg/mL had hyperhomocysteinemia. There were no statistically significant differences between patients with and without Vit B12 deficiency regarding age, mean disease duration, MUST scores, mean hemoglobin levels, H. Pylori IgG positivity and organ involvements (P > 0.05 for all).. Vit B12 deficiency is frequent in SSc and has multiple causes. All patients should be monitored for Vit B12 deficiency. The homocysteine levels seem unlikely to be helpful for confirmation of Vit B12 deficiency.

Topics: Correlation of Data; Cross-Sectional Studies; Female; Gastrointestinal Tract; Helicobacter pylori; Homocysteine; Humans; Immunoglobulin G; Male; Middle Aged; Nutritional Status; Scleroderma, Systemic; Vitamin B 12; Vitamin B 12 Deficiency

To investigate whether patients with systemic sclerosis (SSc) have raised homocysteine (Hcy) plasma levels, thought to be an independent risk factor for vascular disease, and to study the relationship between Hcy and endothelial damage, and between Hcy and methylene-tetrahydrofolate reductase (MTHFR) genotypes, and patients' vitamin nutritional status, which are among the more frequent causes of hyperhomocysteinemia.. We measured Hcy, von Willebrand factor (vWF), folic acid, and vitamin B12 plasma levels and analyzed the frequencies of MTHFR mutations in 30 patients with SSc and 12 patients with primary Raynaud's phenomenon (RP); 29 healthy subjects served as controls.. Patients with SSc had higher Hcy and vWF concentrations than those with RP (p < 0.01 and p < 0.02, respectively) or controls (p < 0.02 and p < 0.0001, respectively). Folic acid and vitamin B12 were lower in SSc than in RP (p < 0.01 and p < 0.02, respectively) or controls (p < 0.05). MTHFR genotype did not influence Hcy, folate, or vitamin B12 concentrations, but patients homozygous for the mutant gene had higher vWF levels.. Patients with SSc, but not those with RP, had significantly higher Hcy and vWF plasma levels. Nutritional rather than inherited factors seem to have a pathogenic role in SSc hyperhomocysteinemia.

Topics: Adult; Aged; Female; Folic Acid; Genotype; Homocysteine; Homozygote; Humans; Male; Methylenetetrahydrofolate Reductase (NADPH2); Middle Aged; Mutation; Osmolar Concentration; Oxidoreductases Acting on CH-NH Group Donors; Raynaud Disease; Scleroderma, Systemic; Vitamin B 12; von Willebrand Factor

Topics: Bone Resorption; Child; Diagnosis, Differential; Female; Foot; Friedreich Ataxia; Glycosaminoglycans; Hand; Humans; Infant; Male; Peripheral Nervous System Diseases; Psoriasis; Radiography; Scleroderma, Systemic; Sex Factors; Syringomyelia; Tabes Dorsalis; Thromboangiitis Obliterans; Tuberculosis, Osteoarticular; Ulcer; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Adult; Aged; Celiac Disease; Duodenum; Esophagus; Female; Humans; Intestinal Mucosa; Intestine, Small; Jejunum; Male; Middle Aged; Radiography; Scleroderma, Systemic; Vitamin B 12

Topics: Adult; Celiac Disease; Chloramphenicol; Female; Humans; Intestinal Diseases; Intestinal Obstruction; Intestine, Small; Jejunum; Malabsorption Syndromes; Middle Aged; Pneumatosis Cystoides Intestinalis; Pneumoperitoneum; Radiography; Scleroderma, Systemic; Tetracycline; Vitamin B 12; Xylose

Topics: Adolescent; Adult; Aged; Arteriosclerosis; Blood; Cholecystitis; Cobalt Isotopes; Colitis, Ulcerative; Creatine; Female; Glomerular Filtration Rate; Glomerulonephritis; Goiter; Humans; Hypertension; Inulin; Male; Middle Aged; Nephrocalcinosis; Pyelonephritis; Scleroderma, Systemic; Urine; Vitamin B 12

Topics: Ascorbic Acid; Collagen Diseases; Corrinoids; Cystitis; Cystitis, Interstitial; Drug Therapy; Humans; Lupus Erythematosus, Systemic; Pyridoxine; Scleroderma, Systemic; Ulcer; Vitamin B 12

Topics: Humans; Scleroderma, Systemic; Vitamin B 12

Topics: Corrinoids; Fermentation; Hematinics; Humans; Leukemia; Scleroderma, Localized; Scleroderma, Systemic; Vitamin B 12