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Unexpected high plasma cobalamin : proposal for a diagnostic strategy.
Clin Chem Lab Med. 2013 Mar 01; 51(3):489-96.CC

Abstract

It is well-established that more than 8% of patients examined for vitamin B12 deficiency unexpectedly have increased plasma levels of the vitamin, but so far there are no guidelines for the clinical interpretation of such findings. In this review, we summarise known associations between high plasma cobalamin and diseases. We report associations mainly with cancer, liver and kidney diseases, but also with a number of other diagnostic entities. The pathogenic background is poorly understood and is likely to be multi-factorial, involving increased concentrations of one or both of the circulating cobalamin binding proteins, transcobalamin and haptocorrin. Based on current knowledge, we suggest a strategy for the clinical interpretation of unexpected high plasma cobalamin. Since a number of the associated diseases are critical and life-threatening, the strategy promotes the concept of 'think the worst first'. It is important to realise that high cobalamin levels can be an unspecific marker for cancer. If this can be ruled out, diseases of the liver and kidney should be considered.

Authors+Show Affiliations

Department of Clinical Biochemistry, Aarhus University Hospital, Norrebrogade 44, 8000Aarhus C, Denmark. johan.frederik.berg.arendt@sun.au.dkNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Review

Language

eng

PubMed ID

23241600

Citation

Arendt, Johan F B., and Ebba Nexo. "Unexpected High Plasma Cobalamin : Proposal for a Diagnostic Strategy." Clinical Chemistry and Laboratory Medicine, vol. 51, no. 3, 2013, pp. 489-96.
Arendt JF, Nexo E. Unexpected high plasma cobalamin : proposal for a diagnostic strategy. Clin Chem Lab Med. 2013;51(3):489-96.
Arendt, J. F., & Nexo, E. (2013). Unexpected high plasma cobalamin : proposal for a diagnostic strategy. Clinical Chemistry and Laboratory Medicine, 51(3), 489-96. https://doi.org/10.1515/cclm-2012-0545
Arendt JF, Nexo E. Unexpected High Plasma Cobalamin : Proposal for a Diagnostic Strategy. Clin Chem Lab Med. 2013 Mar 1;51(3):489-96. PubMed PMID: 23241600.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Unexpected high plasma cobalamin : proposal for a diagnostic strategy. AU - Arendt,Johan F B, AU - Nexo,Ebba, PY - 2012/08/27/received PY - 2012/10/24/accepted PY - 2012/12/18/entrez PY - 2012/12/18/pubmed PY - 2013/9/6/medline SP - 489 EP - 96 JF - Clinical chemistry and laboratory medicine JO - Clin Chem Lab Med VL - 51 IS - 3 N2 - It is well-established that more than 8% of patients examined for vitamin B12 deficiency unexpectedly have increased plasma levels of the vitamin, but so far there are no guidelines for the clinical interpretation of such findings. In this review, we summarise known associations between high plasma cobalamin and diseases. We report associations mainly with cancer, liver and kidney diseases, but also with a number of other diagnostic entities. The pathogenic background is poorly understood and is likely to be multi-factorial, involving increased concentrations of one or both of the circulating cobalamin binding proteins, transcobalamin and haptocorrin. Based on current knowledge, we suggest a strategy for the clinical interpretation of unexpected high plasma cobalamin. Since a number of the associated diseases are critical and life-threatening, the strategy promotes the concept of 'think the worst first'. It is important to realise that high cobalamin levels can be an unspecific marker for cancer. If this can be ruled out, diseases of the liver and kidney should be considered. SN - 1437-4331 UR - https://www.unboundmedicine.com/medline/citation/23241600/Unexpected_high_plasma_cobalamin_:_proposal_for_a_diagnostic_strategy_ L2 - https://www.degruyter.com/document/doi/10.1515/cclm-2012-0545 DB - PRIME DP - Unbound Medicine ER -