[Cobalamin deficiency despite normal serum cobalamins]. 1992

K Rasmussen, and K O Pedersen, and S Sillesen
Arhus Kommunehospital, klinisk-kemisk afdeling.

In a man aged 77 years with normal concentrations of cobalamins in the serum, the concentration of methylmalonic acid in the serum was raised (2,920 nmol/l; 50-370 nmol/l). (The serum cobalamin concentrations were measured both by an old R-binder method (400 pmol/l; reference interval 200-800 pmol/l) and by a more recent S-binder method (164 pmol/l; 95-585 pmol/l)). Following a saturation dose of vitamin B12, the serum concentration of methylmalonic acid became normal (215 nmol/l) indicating that the patient had had functional cobalamin deficiency. The clinician should never let himself be deceived by a normal concentration of cobalamins in the serum and thus discard a suspicion of cobalamin deficiency. Measurement of serum methyl-malonic acid, which is a sensitive and specific analysis to differentiate between the presence or absence of cobalamin deficiency, is recommended to elucidate cases of doubt.

UI MeSH Term Description Entries
D008297 Male Males
D008764 Methylmalonic Acid A malonic acid derivative which is a vital intermediate in the metabolism of fat and protein. Abnormalities in methylmalonic acid metabolism lead to methylmalonic aciduria. This metabolic disease is attributed to a block in the enzymatic conversion of methylmalonyl CoA to succinyl CoA. Acid, Methylmalonic
D002624 Chemistry, Clinical The specialty of ANALYTIC CHEMISTRY applied to assays of physiologically important substances found in blood, urine, tissues, and other biological fluids for the purpose of aiding the physician in making a diagnosis or following therapy. Clinical Chemistry
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly
D014805 Vitamin B 12 A cobalt-containing coordination compound produced by intestinal micro-organisms and found also in soil and water. Higher plants do not concentrate vitamin B 12 from the soil and so are a poor source of the substance as compared with animal tissues. INTRINSIC FACTOR is important for the assimilation of vitamin B 12. Cobalamin,Cyanocobalamin,Cobalamins,Eritron,Vitamin B12,B 12, Vitamin,B12, Vitamin
D014806 Vitamin B 12 Deficiency A nutritional condition produced by a deficiency of VITAMIN B 12 in the diet, characterized by megaloblastic anemia. Since vitamin B 12 is not present in plants, humans have obtained their supply from animal products, from multivitamin supplements in the form of pills, and as additives to food preparations. A wide variety of neuropsychiatric abnormalities is also seen in vitamin B 12 deficiency and appears to be due to an undefined defect involving myelin synthesis. (From Cecil Textbook of Medicine, 19th ed, p848) Deficiency, Vitamin B 12,Deficiency, Vitamin B12,Vitamin B12 Deficiency,Deficiencies, Vitamin B12,Vitamin B12 Deficiencies

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