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Modern clinical testing strategies in cobalamin and folate deficiency.
Semin Hematol. 1999 Jan; 36(1):35-46.SH

Abstract

Folate or cobalamin deficiencies are usually detected by hematologic abnormalities, such as a macrocytic megaloblastic anemia, or often milder signs, such as hypersegmented neutrophils. In fact, these vitamin deficiencies may be associated with clinical conditions in which anemia and/or macrocytosis are absent, such as neuropsychiatric disorders and inborn errors of folate or cobalamin metabolism. A battery of sensitive tests, including blood vitamin levels, serum methylmaIonic acid and homocysteine assays, and the deoxyuridine suppression test in the bone marrow, allows for early detection of vitamin deficiency. Additional tests may be included to identify the causes of deficiency, such as the Schilling test using crystalline cyanocobalamin, or a modified Schilling test for showing food cobalamin malabsorption. Strategies for diagnosing a vitamin deficiency differ according to the hematologic and clinical presentations. The deleterious effects (aside from anemia) that arise from cobalamin or folate deficiency and include neurological complications, increased risk of vascular disease due to hyperhomocysteinemia, and increased risk of some types of cancer related to folate deficiency, underscore the importance of making an early diagnosis and instituting treatment with the appropriate vitamin in preventing permanent damage.

Authors+Show Affiliations

Service d'Hématologie Biologique, Hôpital Henri Mondor, Creteil, France.No affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

9930567

Citation

Zittoun, J, and R Zittoun. "Modern Clinical Testing Strategies in Cobalamin and Folate Deficiency." Seminars in Hematology, vol. 36, no. 1, 1999, pp. 35-46.
Zittoun J, Zittoun R. Modern clinical testing strategies in cobalamin and folate deficiency. Semin Hematol. 1999;36(1):35-46.
Zittoun, J., & Zittoun, R. (1999). Modern clinical testing strategies in cobalamin and folate deficiency. Seminars in Hematology, 36(1), 35-46.
Zittoun J, Zittoun R. Modern Clinical Testing Strategies in Cobalamin and Folate Deficiency. Semin Hematol. 1999;36(1):35-46. PubMed PMID: 9930567.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Modern clinical testing strategies in cobalamin and folate deficiency. AU - Zittoun,J, AU - Zittoun,R, PY - 1999/2/4/pubmed PY - 1999/2/4/medline PY - 1999/2/4/entrez SP - 35 EP - 46 JF - Seminars in hematology JO - Semin Hematol VL - 36 IS - 1 N2 - Folate or cobalamin deficiencies are usually detected by hematologic abnormalities, such as a macrocytic megaloblastic anemia, or often milder signs, such as hypersegmented neutrophils. In fact, these vitamin deficiencies may be associated with clinical conditions in which anemia and/or macrocytosis are absent, such as neuropsychiatric disorders and inborn errors of folate or cobalamin metabolism. A battery of sensitive tests, including blood vitamin levels, serum methylmaIonic acid and homocysteine assays, and the deoxyuridine suppression test in the bone marrow, allows for early detection of vitamin deficiency. Additional tests may be included to identify the causes of deficiency, such as the Schilling test using crystalline cyanocobalamin, or a modified Schilling test for showing food cobalamin malabsorption. Strategies for diagnosing a vitamin deficiency differ according to the hematologic and clinical presentations. The deleterious effects (aside from anemia) that arise from cobalamin or folate deficiency and include neurological complications, increased risk of vascular disease due to hyperhomocysteinemia, and increased risk of some types of cancer related to folate deficiency, underscore the importance of making an early diagnosis and instituting treatment with the appropriate vitamin in preventing permanent damage. SN - 0037-1963 UR - https://www.unboundmedicine.com/medline/citation/9930567/Modern_clinical_testing_strategies_in_cobalamin_and_folate_deficiency_ L2 - https://medlineplus.gov/folicacid.html DB - PRIME DP - Unbound Medicine ER -
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