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[Diagnosis of vitamin B12 deficiency--time for reflection].
Ugeskr Laeger. 2003 May 05; 165(19):1971-6.UL

Abstract

Since plasma methylmalonic acid (MMA) was introduced in Denmark in 1992 both MMA and P-cobalamins have been increasingly employed to diagnose vitamin B-12 deficiency, and the consumption of vitamin B-12 has been almost doubled during the same period. The controversy about diagnosing vitamin B-12 deficiency is reflected in a huge geographical variation both in requisition of MMA and P-cobalamins and in the vitamin B-12 consumption. On the basis of studies performed so far we conclude that MMA is a reliable method with a good nosographic sensitivity. However, the nosographic specificity is sparsely examined, and the evidence to use MMA as a primary test for diagnosing vitamin B-12 deficiency is still insufficient. We recommend P-cobalamins as the first line test, and if P-cobalamins are in the grey area 125-250 pmol/l we recommend supplementation with MMA. For patients who also have an MMA in the grey area (0.29-0.75 mumol/l) we recommend that the patient is re-examined after about a year.

Authors+Show Affiliations

Klinisk Biokemisk Afdeling, Arhus Kommunehospital, DK-8000 Arhus C. am.hvas@dadlnet.dkNo affiliation info availableNo affiliation info available

Pub Type(s)

English Abstract
Journal Article
Review

Language

dan

PubMed ID

12795070

Citation

Hvas, Anne-Mette, et al. "[Diagnosis of Vitamin B12 Deficiency--time for Reflection]." Ugeskrift for Laeger, vol. 165, no. 19, 2003, pp. 1971-6.
Hvas AM, Ellegaard J, Nexø E. [Diagnosis of vitamin B12 deficiency--time for reflection]. Ugeskr Laeger. 2003;165(19):1971-6.
Hvas, A. M., Ellegaard, J., & Nexø, E. (2003). [Diagnosis of vitamin B12 deficiency--time for reflection]. Ugeskrift for Laeger, 165(19), 1971-6.
Hvas AM, Ellegaard J, Nexø E. [Diagnosis of Vitamin B12 Deficiency--time for Reflection]. Ugeskr Laeger. 2003 May 5;165(19):1971-6. PubMed PMID: 12795070.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Diagnosis of vitamin B12 deficiency--time for reflection]. AU - Hvas,Anne-Mette, AU - Ellegaard,Jørgen, AU - Nexø,Ebba, PY - 2003/6/11/pubmed PY - 2003/7/2/medline PY - 2003/6/11/entrez SP - 1971 EP - 6 JF - Ugeskrift for laeger JO - Ugeskr Laeger VL - 165 IS - 19 N2 - Since plasma methylmalonic acid (MMA) was introduced in Denmark in 1992 both MMA and P-cobalamins have been increasingly employed to diagnose vitamin B-12 deficiency, and the consumption of vitamin B-12 has been almost doubled during the same period. The controversy about diagnosing vitamin B-12 deficiency is reflected in a huge geographical variation both in requisition of MMA and P-cobalamins and in the vitamin B-12 consumption. On the basis of studies performed so far we conclude that MMA is a reliable method with a good nosographic sensitivity. However, the nosographic specificity is sparsely examined, and the evidence to use MMA as a primary test for diagnosing vitamin B-12 deficiency is still insufficient. We recommend P-cobalamins as the first line test, and if P-cobalamins are in the grey area 125-250 pmol/l we recommend supplementation with MMA. For patients who also have an MMA in the grey area (0.29-0.75 mumol/l) we recommend that the patient is re-examined after about a year. SN - 0041-5782 UR - https://www.unboundmedicine.com/medline/citation/12795070/[Diagnosis_of_vitamin_B12_deficiency__time_for_reflection]_ DB - PRIME DP - Unbound Medicine ER -