Vitamin b12 cobalamin deficiency in elderly patients. Vitamin b12 deficiency is a common condition, and many are undiagnosed. Cobalamin vitamin b12 is essential for several important. Some people are at risk because their bodies cannot absorb enough vitamin b12 from foods. Vitamin b12 deficiency wikipedia, vitamin b12 deficiency, also known as cobalamin deficiency, is the medical condition of low blood and tissue levels of vitamin b12 in mild deficiency, a person may feel tired and have a reduced number of red blood cells in moderate deficiency, soreness of the tongue may occur, and the beginning of neurological. There is still no ideal test for measuring vitamin b 12 deficiency.
Serum holotranscobalamin level, which is reduced in vitamin b. Vitamin b12 deficiency and bone health new england journal. Vitamin b12 deficiency presenting as pseudothrombotic. Hemolysis due to vitamin b12 deficiency is a rare presentation requiring high clinical suspicion to allow for early diagnosis and treatment. A number of individuals with vitamin b 12 deficiency may present with the classic megaloblastic anemia. Box 2 outlines when testing for vitamin b 12 deficiency should be considered. Vitamin b 12 cobalamin, cbl is an essential nutrient in human metabolism. Vitamin b12 deficiency should be treated as early as possible. Autoimmune gastritis pernicious anemia is the most common cause of severe deficiency.
In a healthy person a wellbalanced diet will provide sufficient amounts of vitamin b12. Causes of the deficiency include, most frequently, foodcobalamin malabsorption syndrome 60% of all cases. It has been suggested that an increased intake of calcium reverses the vitamin b12 malabsorption induced by metformin. Symptoms related to vitamin b 12 deficiency may be diverse and vary from neurologic to psychiatric. Vitamin b12, assay for folic acid, assay of homocystine. A 56yearold woman presented with a fourmonth history of progressive cognitive decline, weakness, incoordination, and. Vitamin b12 is only found in foods that come from animal sources such as fish, beef, dairy products, and eggs. Our patient achieved complete response within 14 days. Measuring the serum cobalamin level remains the preferred choice. Spurious elevations of vitamin b12 with pernicious anemia. A mild deficiency of vitamin b12 may not produce symptoms.
Neurologic manifestations of vitamin b12 deficiency. Functionally, b 12 is the cofactor for methionine synthase and methylmalonyl coa mutase. Methodologic problems may compromise the sensitivity and specificity of current vitamin b 12 assays. The manifestation of vitamin b12 deficiency ranges from subtle, nonspecific clinical features to serious neurological and neuropsychiatric complication if left. Vitamin b12 deficiency cobalamin deficiency is a condition that results when there is too little vitamin b12 in the body. For example, vitamin b12 deficiency has a wellrecognized neurologic syndrome that is characterized by cognitive and psychiatric disturbances, as well as by subacute combined degeneration of the spinal cord, and peripheral neuropathy 1,2 exclusion of vitamin b12 deficiency as an explanation of dementia is a standard procedure in the diagnosis.
Although cobalamin vitamin b 12 deficiency was described over a century ago, it is still difficult to establish the correct diagnosis and prescribe the right treatment. As this study was done in limited geographical area and sample size being small, further larger studies are needed before generalizing these results. Neurologic manifestations of vitamin b 12 deficiency katalin scherer, m. Early identification and prompt treatment of vitamin b12 deficiency is of utmost importance, because it is a reversible cause of ineffective hematopoiesis,1 in contrast to myelodysplastic syndrome or acute myeloid leukemia, which are irreversible disorders of ineffective hematopoiesis. Vitamin b12 deficiency is a low level of vitamin b12 in your body. Vitamin b12 deficiency is estimated to affect 10%15% of people over the age of 60, and the laboratory diagnosis is usually based on low serum vitamin. We use cookies to make interactions with our website easy and meaningful, to better understand the use of our services, and to tailor advertising. In moderate deficiency, soreness of the tongue may occur, and the beginning of neurological symptoms, including abnormal sensations such as pins and needles. Thus, selective vitamin b 12 malabsorption is not associated with a morphologically identifiable lesion, and the absorptive defect does not seem to result from lack of ileal receptors for ifb 12. Severe deficiency of vitamin b12 can result in serious illness, or even death.
Without treatment, it can cause permanent nerve damage over time. Vitamin b12 also known as cobalamin is a b vitamin that has an important role in cellular metabolism, especially in dna synthesis, methylation and mitochondrial metabolism. Coelho d, suormal t, stucki m, lernerellis jp, rosenblatt ds, newbold r. Vitamin b 12 deficiency, also known as cobalamin deficiency, is the medical condition of low blood and tissue levels of vitamin b 12. Vitamin b 12 deficiency is a common cause of megaloblastic anemia, various neuropsychiatric symptoms, and other clinical manifestations. Pernicious anemia is a kind of anemia that happens when the body is not able to absorb vitamin b12 through the digestive tract. Pdf vitamin b12 deficiency mimicking acute leukemia. Total normal body stores of vitamin b12 are in the range of 25 mg. Neurologic manifestations of vitamin b12 deficiency nejm. Deficiency takes at least 12 years to develop once vitamin b12 intake ceases. Vitamin solubility disease caused by deficiency vitamin a fat. Pernicious anemia, due to autoantibodies to intrinsic factor in parietal cells, is the most common cause of vitamin b12 deficiency. In mild deficiency, a person may feel tired and have a reduced number of red blood cells anemia. Genetic diseases of vitamin b 12 utilisation constitute an important fraction of inherited newborn disease.
Thoughts on bvitamins and dementia pubmed central pmc. As with other vitamins, however, only a small amount of vitamin b12 is required for normal functioning of the body. The national institute of health recommends daily intake of vitamin b12 at 2. Webmd tells you about symptoms of a vitamin b12 deficiency and how it can be treated. Several investigations reflecting physiological, static, and functional b 12 status are available table. Pdf vitamin b12 cobalamin deficiency is a common cause of macrocytic anemia and has been implicated in a spectrum of neuropsychiatric disorders. Vitamin b 12 or cobalamin deficiency occurs frequently 20% among elderly people, but it is often unrecognized because the clinical manifestations are subtle. Other symptoms of vitamin b12 deficiency include problems with balance, depression, confusion, dementia, poor memory, and soreness of the mouth or tongue. Pancytopenia from severe cobalamin vitamin b12 deficiency in. Deficiency of vitamin b12 causes impaired nucleic acid metabolism, resulting in asynchrony between. Vitamin b 12 deficiency causes hematologic and neuropsychiatric manifestations that may occur together or independently. To function as a cofactor, b 12 must be metabolised through a complex pathway that modifies its structure and takes. Plus you will find an additional five articles in this valuable collection to help.
Drug induced b12 deficiency includes metformin, trimethoprim, colchicine, neomycin, anticonvulsants, long term use of ppi or h2 antagonist drugs. If you have low levels of stomach acid, you may not absorb enough vitamin b12. Appropriate laboratory evaluation, including methylmalonic acid. The article ends with the authors clinical recommendations.
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