Clinical implications of high cobalamin blood levels for internal medecine
Clinical implications of high cobalamin blood levels for internal medecine
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DOI：
10.1016/j.revmed.2007.07.007
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发表时间：
2008-03-01
影响因子：
0.9
通讯作者：
Durand, J. -M.
中科院分区：
文献类型：
--
作者：
Chiche, L.;Jean, R.;Durand, J. -M.
目的. - 钴胺素（维生素B12）缺乏症的高发病率导致内科频繁服用这种维生素，可能会发现钴胺素的血液水平异常高。本研究的目的是估计潜在的疾病和潜在的诊断相关性高钴胺素血液水平在内科。- 我们进行了一项回顾性研究，包括2005年12月至2006年7月的住院患者，他们的血液中钴胺素水平较高，与我们的实验室正常值（200-950 pg/mL）一致。- 高钴胺素血液水平并不罕见（所有剂量的18.5%），大多数情况下，它与一种或几种疾病有关，其中包括急性和慢性肝病（通常是酒精引起的），各种肿瘤，恶性血液病（骨髓增生异常，骨髓增生性疾病，多发性骨髓瘤），肾功能不全和一过性血液学异常（嗜中性白细胞增多症，嗜酸性粒细胞增多症）。维生素B12补充剂和慢性粒细胞白血病占所有高维生素血症的不到5%。钴胺素血药浓度与患者基础疾病数无相关性。然而，非常高的钴胺素血液水平（>1275 pg/mL）与恶性血液病显著相关（p
Purpose. - The high incidence of cobalamin (vitamin B12) deficiency results in frequent dosages of this vitamin in a department of internal medicine may reveal paradoxically high blood levels of cobalamin. The objective of the study was to estimate underlying diseases and potential diagnostic relevance of high cobalamin blood levels in internal medicine.Methods. - A retrospective study was conducted, including in-patients from December 2005 to July 2006 presenting high cobalamin blood levels, as determined with our laboratory normal values (200-950 pg/mL).Results. - High cobalamin blood level is not unusual (18.5% of all dosages) and, most of time, it is associated with one or several diseases, among which acute and chronic liver diseases (often of alcoholic origin), various neoplasias, malignant hemopathies (myelodysplasia, myeloproliferative diseases, multiple myeloma), renal insufficiency and transient hematologic abnormalities (neutrophilic hyperleucocytosis, hypereosinophilia). Vitamin B12 supplementation and chronic myeloid leukemia represent less than 5% of all hypervitaminemia. There is no correlation between the level of cobalamin blood level and the number of underlying diseases for each patients. However, very high cobalamin blood levels (>1275 pg/mL) are significantly associated to malignant hemopathies (p