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Serum methylmalonic acid and total homocysteine in patients with suspected cobalamin deficiency: a clinical study based on gastrointestinal histopathological findings.
Am J Hematol. 1997 Dec; 56(4):230-8.AJ

Abstract

We compared the sensitivity and specificity of the two metabolite tests, methylmalonic acid (MMA) and total homocysteine (Hcy) in serum, and serum cobalamin (Cbl) in patients referred to our hospital because of suspected cobalamin deficiency and a serum cobalamin value at the referring unit <200 pmol/L. All 111 patients included were investigated using upper gastrointestinal endoscopy with biopsy specimens taken from the gastric and duodenal mucosa to find a morphological basis for cobalamin malabsorption as well as the Schilling test for the validation of the serum tests. All patients were treated with cobalamin and new blood samples were taken after 4 weeks. We found no difference in sensitivity and specificity between serum MMA, Hcy, and Cbl in identifying patients with and without conditions compatible with cobalamin malabsorption. Elevated serum MMA and Hcy were also found in about 15% of the group of patients with normal Schilling tests and without a morphological basis for cobalamin malabsorption. Moreover, most patients in this group responded with decreased values of the metabolite tests following cobalamin treatment, suggesting that neither elevated metabolites nor a decrease in these values following cobalamin treatment are specific for cobalamin deficiency.

Authors+Show Affiliations

Department of Internal Medicine, Borås Central Hospital, Sweden.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

9395184

Citation

Lindgren, A, et al. "Serum Methylmalonic Acid and Total Homocysteine in Patients With Suspected Cobalamin Deficiency: a Clinical Study Based On Gastrointestinal Histopathological Findings." American Journal of Hematology, vol. 56, no. 4, 1997, pp. 230-8.
Lindgren A, Swolin B, Nilsson O, et al. Serum methylmalonic acid and total homocysteine in patients with suspected cobalamin deficiency: a clinical study based on gastrointestinal histopathological findings. Am J Hematol. 1997;56(4):230-8.
Lindgren, A., Swolin, B., Nilsson, O., Johansson, K. W., & Kilander, A. F. (1997). Serum methylmalonic acid and total homocysteine in patients with suspected cobalamin deficiency: a clinical study based on gastrointestinal histopathological findings. American Journal of Hematology, 56(4), 230-8.
Lindgren A, et al. Serum Methylmalonic Acid and Total Homocysteine in Patients With Suspected Cobalamin Deficiency: a Clinical Study Based On Gastrointestinal Histopathological Findings. Am J Hematol. 1997;56(4):230-8. PubMed PMID: 9395184.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Serum methylmalonic acid and total homocysteine in patients with suspected cobalamin deficiency: a clinical study based on gastrointestinal histopathological findings. AU - Lindgren,A, AU - Swolin,B, AU - Nilsson,O, AU - Johansson,K W, AU - Kilander,A F, PY - 1997/12/12/pubmed PY - 2000/6/20/medline PY - 1997/12/12/entrez SP - 230 EP - 8 JF - American journal of hematology JO - Am J Hematol VL - 56 IS - 4 N2 - We compared the sensitivity and specificity of the two metabolite tests, methylmalonic acid (MMA) and total homocysteine (Hcy) in serum, and serum cobalamin (Cbl) in patients referred to our hospital because of suspected cobalamin deficiency and a serum cobalamin value at the referring unit <200 pmol/L. All 111 patients included were investigated using upper gastrointestinal endoscopy with biopsy specimens taken from the gastric and duodenal mucosa to find a morphological basis for cobalamin malabsorption as well as the Schilling test for the validation of the serum tests. All patients were treated with cobalamin and new blood samples were taken after 4 weeks. We found no difference in sensitivity and specificity between serum MMA, Hcy, and Cbl in identifying patients with and without conditions compatible with cobalamin malabsorption. Elevated serum MMA and Hcy were also found in about 15% of the group of patients with normal Schilling tests and without a morphological basis for cobalamin malabsorption. Moreover, most patients in this group responded with decreased values of the metabolite tests following cobalamin treatment, suggesting that neither elevated metabolites nor a decrease in these values following cobalamin treatment are specific for cobalamin deficiency. SN - 0361-8609 UR - https://www.unboundmedicine.com/medline/citation/9395184/Serum_methylmalonic_acid_and_total_homocysteine_in_patients_with_suspected_cobalamin_deficiency:_a_clinical_study_based_on_gastrointestinal_histopathological_findings_ L2 - https://onlinelibrary.wiley.com/resolve/openurl?genre=article&amp;sid=nlm:pubmed&amp;issn=0361-8609&amp;date=1997&amp;volume=56&amp;issue=4&amp;spage=230 DB - PRIME DP - Unbound Medicine ER -