TY - JOUR
T1 - Current hematological findings in cobalamin deficiency. A study of 201 consecutive patients with documented cobalamin deficiency
AU - Andrès, E.
AU - Affenberger, S.
AU - Zimmer, J.
AU - Vinzio, S.
AU - Grosu, D.
AU - Pistol, G.
AU - Maloisel, F.
AU - Weitten, T.
AU - Kaltenbach, G.
AU - Blicklé, J. F.
PY - 2006/2
Y1 - 2006/2
N2 - With the introduction of automated assays for measuring serum cobalamin levels over the last decades, the hematological manifestations related to cobalamin deficiency have been changed from the description reported in 'old' studies or textbooks. We studied the hematological manifestations or abnormalities in 201 patients (median age: 67 ± 6 years) with well-documented cobalamin deficiency (mean serum vitamin B12 levels 125 ± 47 pg/ml) extracted from an observational cohort study (1995-2003). Assessment included clinical features, blood count and morphological review. Hematological abnormalities were reported in at least two-third of the patients: anemia (37%), leukopenia (13.9%), thrombopenia (9.9%), macrocytosis (54%) and hypegmented neutrophils (32%). The mean hemoglobin level was 10.3 ± 0.4 g/dl and the mean erythrocyte cell volume 98.9 ± 25.6 fl. Approximately 10% of the patients have life-threatening hematological manifestations with documented symptomatic pancytopenia (5%), 'pseudo' thrombotic microangiopathy (Moschkowitz; 2.5%), severe anemia (defined as Hb levels <6 g/dl; 2.5%) and hemolytic anemia (1.5%). Correction of the hematological abnormalities was achieved in at least two-thirds of the patients, equally well in patients treated with either intramuscular or oral crystalline cyanocobalamin. This study, based on real data from a single institution with a large number of consecutive patients with well-documented cobalamin deficiency, confirms several 'older' findings that were previously reported before the 1990s in several studies and in textbooks.
AB - With the introduction of automated assays for measuring serum cobalamin levels over the last decades, the hematological manifestations related to cobalamin deficiency have been changed from the description reported in 'old' studies or textbooks. We studied the hematological manifestations or abnormalities in 201 patients (median age: 67 ± 6 years) with well-documented cobalamin deficiency (mean serum vitamin B12 levels 125 ± 47 pg/ml) extracted from an observational cohort study (1995-2003). Assessment included clinical features, blood count and morphological review. Hematological abnormalities were reported in at least two-third of the patients: anemia (37%), leukopenia (13.9%), thrombopenia (9.9%), macrocytosis (54%) and hypegmented neutrophils (32%). The mean hemoglobin level was 10.3 ± 0.4 g/dl and the mean erythrocyte cell volume 98.9 ± 25.6 fl. Approximately 10% of the patients have life-threatening hematological manifestations with documented symptomatic pancytopenia (5%), 'pseudo' thrombotic microangiopathy (Moschkowitz; 2.5%), severe anemia (defined as Hb levels <6 g/dl; 2.5%) and hemolytic anemia (1.5%). Correction of the hematological abnormalities was achieved in at least two-thirds of the patients, equally well in patients treated with either intramuscular or oral crystalline cyanocobalamin. This study, based on real data from a single institution with a large number of consecutive patients with well-documented cobalamin deficiency, confirms several 'older' findings that were previously reported before the 1990s in several studies and in textbooks.
KW - Cobalamin
KW - Cobalamin deficiency
KW - Food-cobalamin malabsorption
KW - Hematological findings
KW - Pernicious anemia
KW - Vitamin B12
UR - http://www.scopus.com/inward/record.url?scp=33645064021&partnerID=8YFLogxK
U2 - 10.1111/j.1365-2257.2006.00755.x
DO - 10.1111/j.1365-2257.2006.00755.x
M3 - Article
C2 - 16430460
AN - SCOPUS:33645064021
SN - 1751-5521
VL - 28
SP - 50
EP - 56
JO - International Journal of Laboratory Hematology
JF - International Journal of Laboratory Hematology
IS - 1
ER -