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The pathophysiology of elevated vitamin B12 in clinical practice.
QJM 2013; 106(6):505-15QJM

Abstract

Hypercobalaminemia (high serum vitamin B12 levels) is a frequent and underestimated anomaly. Clinically, it can be paradoxically accompanied by signs of deficiency, reflecting a functional deficiency linked to qualitative abnormalities, which are related to defects in tissue uptake and action of vitamin B12. The aetiological profile of high serum cobalamin predominantly encompasses severe disease entities for which early diagnosis is critical for prognosis. These entities are essentially comprised of solid neoplasms, haematological malignancies and liver and kidney diseases. This review reflects the potential importance of the vitamin B12 assay as an early diagnostic marker of these diseases. A codified approach is needed to determine the potential indications of a search for high serum cobalamin and the practical clinical strategy to adopt upon discovery of elevated cobalamin levels. While low serum cobalamin levels do not necessarily imply deficiency, an abnormally high serum cobalamin level forms a warning sign requiring exclusion of a number of serious underlying pathologies. Functional cobalamin deficiency can thus occur at any serum level.

Authors+Show Affiliations

Service de Médecine Interne, Diabète et Maladies Métaboliques, Clinique Médicale B, Hôpital Civil, Hôpitaux Universitaires de Strasbourg, 1 porte de l'Hôpital, 67091 Strasbourg Cedex, France. emmanuel.andres@chru-strasbourg.frNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

23447660

Citation

Andrès, E, et al. "The Pathophysiology of Elevated Vitamin B12 in Clinical Practice." QJM : Monthly Journal of the Association of Physicians, vol. 106, no. 6, 2013, pp. 505-15.
Andrès E, Serraj K, Zhu J, et al. The pathophysiology of elevated vitamin B12 in clinical practice. QJM. 2013;106(6):505-15.
Andrès, E., Serraj, K., Zhu, J., & Vermorken, A. J. (2013). The pathophysiology of elevated vitamin B12 in clinical practice. QJM : Monthly Journal of the Association of Physicians, 106(6), pp. 505-15. doi:10.1093/qjmed/hct051.
Andrès E, et al. The Pathophysiology of Elevated Vitamin B12 in Clinical Practice. QJM. 2013;106(6):505-15. PubMed PMID: 23447660.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The pathophysiology of elevated vitamin B12 in clinical practice. AU - Andrès,E, AU - Serraj,K, AU - Zhu,J, AU - Vermorken,A J M, Y1 - 2013/02/27/ PY - 2013/3/1/entrez PY - 2013/3/1/pubmed PY - 2014/2/8/medline SP - 505 EP - 15 JF - QJM : monthly journal of the Association of Physicians JO - QJM VL - 106 IS - 6 N2 - Hypercobalaminemia (high serum vitamin B12 levels) is a frequent and underestimated anomaly. Clinically, it can be paradoxically accompanied by signs of deficiency, reflecting a functional deficiency linked to qualitative abnormalities, which are related to defects in tissue uptake and action of vitamin B12. The aetiological profile of high serum cobalamin predominantly encompasses severe disease entities for which early diagnosis is critical for prognosis. These entities are essentially comprised of solid neoplasms, haematological malignancies and liver and kidney diseases. This review reflects the potential importance of the vitamin B12 assay as an early diagnostic marker of these diseases. A codified approach is needed to determine the potential indications of a search for high serum cobalamin and the practical clinical strategy to adopt upon discovery of elevated cobalamin levels. While low serum cobalamin levels do not necessarily imply deficiency, an abnormally high serum cobalamin level forms a warning sign requiring exclusion of a number of serious underlying pathologies. Functional cobalamin deficiency can thus occur at any serum level. SN - 1460-2393 UR - https://www.unboundmedicine.com/medline/citation/23447660/The_pathophysiology_of_elevated_vitamin_B12_in_clinical_practice_ L2 - https://academic.oup.com/qjmed/article-lookup/doi/10.1093/qjmed/hct051 DB - PRIME DP - Unbound Medicine ER -