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[Diagnosis of vitamin B12 deficiency: only apparently child's play].
Schweiz Med Wochenschr. 1999 Jun 12; 129(23):861-72.SM

Abstract

We performed a systematic literature search for diagnostic criteria in establishing cobalamin deficiency. The diagnostic procedure is particularly uncertain in elderly patients with neurological symptoms and in cases with borderline cobalamin values. In any patient with suspected cobalamin deficiency we recommend analysing a full blood count and determining cobalamin concentration in a serum sample. Particularly in elderly patients and cases with neurological symptoms presenting borderline cobalamin values and no abnormalities in the blood count, we recommend further investigation with methylmalonic acid, homocystein and Schilling test. These additional tests should make it possible to decide whether to recommend lifelong substitution with cobalamin. Various cobalamin assays, Schilling test, food cobalamin test, gastroscopic evaluation and the problems surrounding these assays in the elderly are discussed. Our own experience with methylmalonic acid, homocystein determination and food cobalamin test did not reveal a simple diagnostic procedure in such cases. We conclude that there is still no "gold standard" for diagnostic procedure in the special cases mentioned.

Authors+Show Affiliations

MRC Clinical Sciences Centre, Imperial College School of Medicine, Hammersmith Hospital, London.No affiliation info available

Pub Type(s)

English Abstract
Journal Article
Review

Language

ger

PubMed ID

10420442

Citation

Bächli, E, and J Fehr. "[Diagnosis of Vitamin B12 Deficiency: Only Apparently Child's Play]." Schweizerische Medizinische Wochenschrift, vol. 129, no. 23, 1999, pp. 861-72.
Bächli E, Fehr J. [Diagnosis of vitamin B12 deficiency: only apparently child's play]. Schweiz Med Wochenschr. 1999;129(23):861-72.
Bächli, E., & Fehr, J. (1999). [Diagnosis of vitamin B12 deficiency: only apparently child's play]. Schweizerische Medizinische Wochenschrift, 129(23), 861-72.
Bächli E, Fehr J. [Diagnosis of Vitamin B12 Deficiency: Only Apparently Child's Play]. Schweiz Med Wochenschr. 1999 Jun 12;129(23):861-72. PubMed PMID: 10420442.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Diagnosis of vitamin B12 deficiency: only apparently child's play]. AU - Bächli,E, AU - Fehr,J, PY - 1999/7/27/pubmed PY - 2000/2/19/medline PY - 1999/7/27/entrez SP - 861 EP - 72 JF - Schweizerische medizinische Wochenschrift JO - Schweiz Med Wochenschr VL - 129 IS - 23 N2 - We performed a systematic literature search for diagnostic criteria in establishing cobalamin deficiency. The diagnostic procedure is particularly uncertain in elderly patients with neurological symptoms and in cases with borderline cobalamin values. In any patient with suspected cobalamin deficiency we recommend analysing a full blood count and determining cobalamin concentration in a serum sample. Particularly in elderly patients and cases with neurological symptoms presenting borderline cobalamin values and no abnormalities in the blood count, we recommend further investigation with methylmalonic acid, homocystein and Schilling test. These additional tests should make it possible to decide whether to recommend lifelong substitution with cobalamin. Various cobalamin assays, Schilling test, food cobalamin test, gastroscopic evaluation and the problems surrounding these assays in the elderly are discussed. Our own experience with methylmalonic acid, homocystein determination and food cobalamin test did not reveal a simple diagnostic procedure in such cases. We conclude that there is still no "gold standard" for diagnostic procedure in the special cases mentioned. SN - 0036-7672 UR - https://www.unboundmedicine.com/medline/citation/10420442/[Diagnosis_of_vitamin_B12_deficiency:_only_apparently_child's_play]_ L2 - https://medlineplus.gov/olderadulthealth.html DB - PRIME DP - Unbound Medicine ER -