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Functional vitamin B12 deficiency in alcoholics: an intriguing finding in a retrospective study of megaloblastic anemic patients.
Eur J Intern Med. 2010 Apr; 21(2):97-100.EJ

Abstract

BACKGROUND

Measurement of serum cobalamin levels is the standard investigation for assessing Vitamin B12 deficiency. However some patients with clinical evidence of cobalamin deficiency may have serum levels within the normal range. Since falsely increased values of cobalamin can be caused by alcoholic liver disease, we evaluated the impact of this disease on the diagnosis of cobalamin and folic acid deficiency.

METHODS

We reviewed data of 101 adult patients with megaloblastic anemia assessed by measuring in parallel serum cobalamin, serum folate and red blood cell folate levels. Further tests were performed in order to find the cause of megaloblastosis. All patients were treated with cobalamin and/or folic acid therapy.

RESULTS

Vitamin B12, folate and both deficiency were found in 86, 5 and 6 cases respectively. Normal cobalamin serum levels, normal serum and erythrocyte folate levels were found only in 3 patients, all alcohol-dependent, while in another alcoholic borderline vitamin B12 serum levels were found. All the four patients responded to cobalamin treatment.

CONCLUSION

Some alcohol-dependent patients with megaloblastic anemia may respond to vitamin B12 treatment despite normal cobalamin serum levels; therefore in alcoholics caution is urged in the interpretation of these vitamin assays, because of possible functional vitamin B12 deficiency.

Authors+Show Affiliations

Hematology Unit, Ospedale Madonna delle Grazie, ASM Matera, Italy.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

20206879

Citation

Fragasso, Alberto, et al. "Functional Vitamin B12 Deficiency in Alcoholics: an Intriguing Finding in a Retrospective Study of Megaloblastic Anemic Patients." European Journal of Internal Medicine, vol. 21, no. 2, 2010, pp. 97-100.
Fragasso A, Mannarella C, Ciancio A, et al. Functional vitamin B12 deficiency in alcoholics: an intriguing finding in a retrospective study of megaloblastic anemic patients. Eur J Intern Med. 2010;21(2):97-100.
Fragasso, A., Mannarella, C., Ciancio, A., & Sacco, A. (2010). Functional vitamin B12 deficiency in alcoholics: an intriguing finding in a retrospective study of megaloblastic anemic patients. European Journal of Internal Medicine, 21(2), 97-100. https://doi.org/10.1016/j.ejim.2009.11.012
Fragasso A, et al. Functional Vitamin B12 Deficiency in Alcoholics: an Intriguing Finding in a Retrospective Study of Megaloblastic Anemic Patients. Eur J Intern Med. 2010;21(2):97-100. PubMed PMID: 20206879.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Functional vitamin B12 deficiency in alcoholics: an intriguing finding in a retrospective study of megaloblastic anemic patients. AU - Fragasso,Alberto, AU - Mannarella,Clara, AU - Ciancio,Angela, AU - Sacco,Andrea, Y1 - 2010/01/13/ PY - 2009/09/30/received PY - 2009/11/04/revised PY - 2009/11/30/accepted PY - 2010/3/9/entrez PY - 2010/3/9/pubmed PY - 2010/6/3/medline SP - 97 EP - 100 JF - European journal of internal medicine JO - Eur J Intern Med VL - 21 IS - 2 N2 - BACKGROUND: Measurement of serum cobalamin levels is the standard investigation for assessing Vitamin B12 deficiency. However some patients with clinical evidence of cobalamin deficiency may have serum levels within the normal range. Since falsely increased values of cobalamin can be caused by alcoholic liver disease, we evaluated the impact of this disease on the diagnosis of cobalamin and folic acid deficiency. METHODS: We reviewed data of 101 adult patients with megaloblastic anemia assessed by measuring in parallel serum cobalamin, serum folate and red blood cell folate levels. Further tests were performed in order to find the cause of megaloblastosis. All patients were treated with cobalamin and/or folic acid therapy. RESULTS: Vitamin B12, folate and both deficiency were found in 86, 5 and 6 cases respectively. Normal cobalamin serum levels, normal serum and erythrocyte folate levels were found only in 3 patients, all alcohol-dependent, while in another alcoholic borderline vitamin B12 serum levels were found. All the four patients responded to cobalamin treatment. CONCLUSION: Some alcohol-dependent patients with megaloblastic anemia may respond to vitamin B12 treatment despite normal cobalamin serum levels; therefore in alcoholics caution is urged in the interpretation of these vitamin assays, because of possible functional vitamin B12 deficiency. SN - 1879-0828 UR - https://www.unboundmedicine.com/medline/citation/20206879/Functional_vitamin_B12_deficiency_in_alcoholics:_an_intriguing_finding_in_a_retrospective_study_of_megaloblastic_anemic_patients_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0953-6205(09)00243-X DB - PRIME DP - Unbound Medicine ER -