Tags

Type your tag names separated by a space and hit enter

Measuring holotranscobalamin II, an early indicator of negative vitamin B12 balance, by radioimmunoassay in patients with ischemic cerebrovascular disease.
Ann Hematol. 2008 May; 87(5):391-5.AH

Abstract

Circulating homocysteine is a risk factor of cardiovascular and cerebrovascular events. Hyperhomocysteinemia may be an early indicator for vitamin B12 disorders because cobalamin is a cofactor in the remethylation process of homocysteine. Serum holotranscobalamin (holoTC II) becomes decreased before the development of metabolic dysfunction. In this study, we assessed circulating holoTC II to estimate the diagnosis of vitamin B12 deficiency in the first ischemic cerebrovascular attack. We also compared the efficacy of the measurement of plasma holoTC II with the other standard biochemical and hematological markers used to reach the diagnosis of cobalamin deficiency. Forty-five patients (age 71 years (range 35-90), 16 men/29 women) within the first ischemic cerebrovascular event were included in this prospective study. All the enrolled patients have been administered vitamin B12 1 mg intramuscular injection once a day for 10 days. At the baseline and on the tenth day of treatment, plasma levels of holoTC II and the proper biochemical and hematological markers in diagnosing cobalamin deficiency were measured. After admission, anemia and diminished serum vitamin B12 levels were determined to be only 20% (9/45) and 44% (20/45), respectively; 78% (35/45) of the patients had low serum holoTC II (<37 pmol/l). Serum homocysteine was higher in patients (49% of them) who had previously suffered a stroke. Thrombocytopenia, hypersegmentated neutrophils, and indirect hyperbilirubinemia were observed in 20% of the patients. Leukopenia and macrocytosis were not evident in any of them. In 18 of 27 patients (67%) that had low holoTC II levels after joining the study and who remained in the study until the end of cobalamin treatment, serum holoTC II levels returned to normal values. Cobalamin deficiency should be considered in patients with cerebrovascular diseases, even if anemia, elevated mean cell volume, depression of the serum cobalamin, or other classic hematological and/or biochemical abnormalities are lacking. Furthermore, measurement of serum holoTC II looks promising as a first-line of tests for diagnosing early vitamin B12 deficiency.

Authors+Show Affiliations

Department of Internal Medicine, Turgut Ozal Medical Center, Inonu University, Malatya, Turkey. dr.songul1978@yahoo.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article

Language

eng

PubMed ID

17992530

Citation

Serefhanoglu, Songul, et al. "Measuring Holotranscobalamin II, an Early Indicator of Negative Vitamin B12 Balance, By Radioimmunoassay in Patients With Ischemic Cerebrovascular Disease." Annals of Hematology, vol. 87, no. 5, 2008, pp. 391-5.
Serefhanoglu S, Aydogdu I, Kekilli E, et al. Measuring holotranscobalamin II, an early indicator of negative vitamin B12 balance, by radioimmunoassay in patients with ischemic cerebrovascular disease. Ann Hematol. 2008;87(5):391-5.
Serefhanoglu, S., Aydogdu, I., Kekilli, E., Ilhan, A., & Kuku, I. (2008). Measuring holotranscobalamin II, an early indicator of negative vitamin B12 balance, by radioimmunoassay in patients with ischemic cerebrovascular disease. Annals of Hematology, 87(5), 391-5.
Serefhanoglu S, et al. Measuring Holotranscobalamin II, an Early Indicator of Negative Vitamin B12 Balance, By Radioimmunoassay in Patients With Ischemic Cerebrovascular Disease. Ann Hematol. 2008;87(5):391-5. PubMed PMID: 17992530.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Measuring holotranscobalamin II, an early indicator of negative vitamin B12 balance, by radioimmunoassay in patients with ischemic cerebrovascular disease. AU - Serefhanoglu,Songul, AU - Aydogdu,Ismet, AU - Kekilli,Ersoy, AU - Ilhan,Atilla, AU - Kuku,Irfan, Y1 - 2007/11/09/ PY - 2007/05/14/received PY - 2007/10/08/accepted PY - 2007/11/10/pubmed PY - 2008/5/28/medline PY - 2007/11/10/entrez SP - 391 EP - 5 JF - Annals of hematology JO - Ann Hematol VL - 87 IS - 5 N2 - Circulating homocysteine is a risk factor of cardiovascular and cerebrovascular events. Hyperhomocysteinemia may be an early indicator for vitamin B12 disorders because cobalamin is a cofactor in the remethylation process of homocysteine. Serum holotranscobalamin (holoTC II) becomes decreased before the development of metabolic dysfunction. In this study, we assessed circulating holoTC II to estimate the diagnosis of vitamin B12 deficiency in the first ischemic cerebrovascular attack. We also compared the efficacy of the measurement of plasma holoTC II with the other standard biochemical and hematological markers used to reach the diagnosis of cobalamin deficiency. Forty-five patients (age 71 years (range 35-90), 16 men/29 women) within the first ischemic cerebrovascular event were included in this prospective study. All the enrolled patients have been administered vitamin B12 1 mg intramuscular injection once a day for 10 days. At the baseline and on the tenth day of treatment, plasma levels of holoTC II and the proper biochemical and hematological markers in diagnosing cobalamin deficiency were measured. After admission, anemia and diminished serum vitamin B12 levels were determined to be only 20% (9/45) and 44% (20/45), respectively; 78% (35/45) of the patients had low serum holoTC II (<37 pmol/l). Serum homocysteine was higher in patients (49% of them) who had previously suffered a stroke. Thrombocytopenia, hypersegmentated neutrophils, and indirect hyperbilirubinemia were observed in 20% of the patients. Leukopenia and macrocytosis were not evident in any of them. In 18 of 27 patients (67%) that had low holoTC II levels after joining the study and who remained in the study until the end of cobalamin treatment, serum holoTC II levels returned to normal values. Cobalamin deficiency should be considered in patients with cerebrovascular diseases, even if anemia, elevated mean cell volume, depression of the serum cobalamin, or other classic hematological and/or biochemical abnormalities are lacking. Furthermore, measurement of serum holoTC II looks promising as a first-line of tests for diagnosing early vitamin B12 deficiency. SN - 0939-5555 UR - https://www.unboundmedicine.com/medline/citation/17992530/Measuring_holotranscobalamin_II_an_early_indicator_of_negative_vitamin_B12_balance_by_radioimmunoassay_in_patients_with_ischemic_cerebrovascular_disease_ L2 - https://dx.doi.org/10.1007/s00277-007-0406-3 DB - PRIME DP - Unbound Medicine ER -