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[Megaloblastic anemia: rapid and economical study].
Sangre (Barc). 1997 Jun; 42(3):235-8.S

Abstract

The diagnosis of megaloblastic anaemias caused by cobalamine or folate deficiency are still difficult. The dosage of these two substances help to differenciate between both carencies, but it is not determinant of any of them and is an expensive method. Homocisteinuria (HC), methylmalonuria (MMA) and formiminoglutamic acid (FIGLU) are cheap tests which could help in the differential diagnosis, if they are used properly. We report 62 patients to whom we made these test simultaneously. All of the patients received 10 micrograms of vit B12 and after 72 hours, 1 mg/day of folic acid (for 3 days). In both cases waiting for the increase of reticulocytyes up to 150 x 10(9)/L as a form of therapeutic test of diagnosis. By this simple way we have detected 97.9% of specificity for cobalamin deficiency of the MMA test, and only 4.2% for HC. This last test had increased its specificity up to 91.6% in association with the negative FIGLU test. We have also found a high specificity (92.3%) for FIGLU due to the detection of folate deficiency, in opposition with other authors who had described it as low as 50%. We have also compared the costs of the 3 tests with the dosage of cobalamine and folate, and we have found that the formers are 11 times less expensive than the last ones.

Authors+Show Affiliations

Marín GH
Servicio de Hematología, Hospital Interzonal Gral de Agudos San Martin, La Plata, Argentina.
Tentoni J
No affiliation info available
Cicchetti G
No affiliation info available

MeSH

AdolescentAdultAlgorithmsAnemia, MegaloblasticCost ControlDiagnosis, DifferentialDiagnostic Tests, RoutineFemaleFolic AcidFolic Acid DeficiencyFormiminoglutamic AcidHistidineHomocysteineHumansMaleMethylmalonic AcidMiddle AgedPredictive Value of TestsPregnancyPregnancy Complications, HematologicReticulocyte CountRetrospective StudiesSensitivity and SpecificityTime FactorsUrinalysisVitamin B 12Vitamin B 12 Deficiency

Pub Type(s)

Comparative Study
English Abstract
Journal Article

Language

spa

PubMed ID

9381269

Citation

Marín, G H., et al. "[Megaloblastic Anemia: Rapid and Economical Study]." Sangre, vol. 42, no. 3, 1997, pp. 235-8.
Marín GH, Tentoni J, Cicchetti G. [Megaloblastic anemia: rapid and economical study]. Sangre (Barc). 1997;42(3):235-8.
Marín, G. H., Tentoni, J., & Cicchetti, G. (1997). [Megaloblastic anemia: rapid and economical study]. Sangre, 42(3), 235-8.
Marín GH, Tentoni J, Cicchetti G. [Megaloblastic Anemia: Rapid and Economical Study]. Sangre (Barc). 1997;42(3):235-8. PubMed PMID: 9381269.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Megaloblastic anemia: rapid and economical study]. AU - Marín,G H, AU - Tentoni,J, AU - Cicchetti,G, PY - 1997/6/1/pubmed PY - 1998/2/12/medline PY - 1997/6/1/entrez SP - 235 EP - 8 JF - Sangre JO - Sangre (Barc) VL - 42 IS - 3 N2 - The diagnosis of megaloblastic anaemias caused by cobalamine or folate deficiency are still difficult. The dosage of these two substances help to differenciate between both carencies, but it is not determinant of any of them and is an expensive method. Homocisteinuria (HC), methylmalonuria (MMA) and formiminoglutamic acid (FIGLU) are cheap tests which could help in the differential diagnosis, if they are used properly. We report 62 patients to whom we made these test simultaneously. All of the patients received 10 micrograms of vit B12 and after 72 hours, 1 mg/day of folic acid (for 3 days). In both cases waiting for the increase of reticulocytyes up to 150 x 10(9)/L as a form of therapeutic test of diagnosis. By this simple way we have detected 97.9% of specificity for cobalamin deficiency of the MMA test, and only 4.2% for HC. This last test had increased its specificity up to 91.6% in association with the negative FIGLU test. We have also found a high specificity (92.3%) for FIGLU due to the detection of folate deficiency, in opposition with other authors who had described it as low as 50%. We have also compared the costs of the 3 tests with the dosage of cobalamine and folate, and we have found that the formers are 11 times less expensive than the last ones. SN - 0036-4355 UR - https://www.unboundmedicine.com/medline/citation/9381269/[Megaloblastic_anemia:_rapid_and_economical_study]_ DB - PRIME DP - Unbound Medicine ER -