Assessment of Vitamin B12 Deficiency and Risk Factors in Healthy Infants

2020 ◽  
Vol 88 (1) ◽  
pp. 41-49
Author(s):  
Kuchana Suresh Kumar ◽  
Arushi Gahlot Saini ◽  
Savita Verma Attri ◽  
Bhavneet Bharti ◽  
Naveen Sankhyan ◽  
...  
Author(s):  
Sanem Kayhan ◽  
Nazli Gulsoy Kirnap ◽  
Mercan Tastemur

Abstract. Vitamin B12 deficiency may have indirect cardiovascular effects in addition to hematological and neuropsychiatric symptoms. It was shown that the monocyte count-to-high density lipoprotein cholesterol (HDL-C) ratio (MHR) is a novel cardiovascular marker. In this study, the aim was to evaluate whether MHR was high in patients with vitamin B12 deficiency and its relationship with cardiometabolic risk factors. The study included 128 patients diagnosed with vitamin B12 deficiency and 93 healthy controls. Patients with vitamin B12 deficiency had significantly higher systolic blood pressure (SBP), diastolic blood pressure (DBP), MHR, C-reactive protein (CRP) and uric acid levels compared with the controls (median 139 vs 115 mmHg, p < 0.001; 80 vs 70 mmHg, p < 0.001; 14.2 vs 9.5, p < 0.001; 10.2 vs 4 mg/dl p < 0.001; 6.68 vs 4.8 mg/dl, p < 0.001 respectively). The prevalence of left ventricular hypertrophy was higher in vitamin B12 deficiency group (43.8%) than the control group (8.6%) (p < 0.001). In vitamin B12 deficiency group, a positive correlation was detected between MHR and SBP, CRP and uric acid (p < 0.001 r:0.34, p < 0.001 r:0.30, p < 0.001 r:0.5, respectively) and a significant negative correlation was detected between MHR and T-CHOL, LDL, HDL and B12 (p < 0.001 r: −0.39, p < 0.001 r: −0.34, p < 0.001 r: −0.57, p < 0.04 r: −0.17, respectively). MHR was high in vitamin B12 deficiency group, and correlated with the cardiometabolic risk factors in this group, which were SBP, CRP, uric acid and HDL. In conclusion, MRH, which can be easily calculated in clinical practice, can be a useful marker to assess cardiovascular risk in patients with vitamin B12 deficiency.


Author(s):  
Ulf Wike Ljungblad ◽  
Henriette Paulsen ◽  
Lars Mørkrid ◽  
Rolf D. Pettersen ◽  
Helle Borgstrøm Hager ◽  
...  

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
John Rolshoven ◽  
Katelyn Fellows ◽  
Rolando Ania ◽  
Burton J. Tabaac

Background. The term cytotoxic lesions of the corpus callosum (CLOCCs) encompasses the entity reversible splenial lesion syndrome (RESLES). RESLES typically presents with altered levels of consciousness, seizures, and delirium and is distinguished radiographically by reversible focal lesions of the splenium of the corpus callosum. This disease pathology is associated with withdrawal of antiepileptic medications, infections, metabolic disturbance, or high-altitude cerebral edema. Methods. We presented an otherwise healthy 72-year-old female that was consulted for an episode of isolated vertigo lasting four hours. Initial workup included CT head without contrast, CT angiogram head and neck, and MRI brain with and without contrast. The patient experienced recurrent episodes of vertigo at one and four months after initial presentation. An extensive workup at one month included a wide spectrum of laboratory tests and repeat imaging. Results. Noncontrast CT of the head and CT angiogram of the head and neck were reassuring. MRI brain with and without contrast demonstrated hyperintensity in the splenium of the corpus callosum on FLAIR sequencing. A follow-up visit at one month revealed vitamin B12 deficiency and unchanged hyperintensity of the splenium of the corpus callosum. History and workup were negative for typical risk factors associated with RESLES. Conclusion. An otherwise healthy patient who presented with an isolated episode of vertigo was discovered to demonstrate radiographic features consistent with RESLES but lacked the common risk factors and typical presentation of RESLES. This case expands the possible clinical presentation of RESLES and highlights the possible relationship between vitamin B12 deficiency and radiographic features of RESLES.


Stroke ◽  
2015 ◽  
Vol 46 (suppl_1) ◽  
Author(s):  
Zarah Yusuf ◽  
Jayanthi Alamelu ◽  
Ming Lim ◽  
Nomazulu Dlamini

Introduction: Risk factors in childhood stroke are multiple and causality hard to determine. Current guidelines recommend prothrombotic workup, yet yield is variable, often without therapeutic consequence. Raised homocysteine is associated with vitamin B12 deficiency (B12), which is not routinely measured. Hypothesis: We hypothesised that B12 deficiency is a treatable risk factor for stroke in children not reliably identified by analysis of homocysteine only. Method: We retrospectively reviewed paediatric stroke patients admitted to a tertiary care hospital from 2010-2014. All patients with plasma homocysteine measured as part of their prothrombotic workup were selected. All clinical data closest to stroke diagnosis were reviewed. B12 deficiency was defined as low total and/or holo (functional) vitamin B12 with/without raised methylmalonic acid (MMA). Parental prothrombotic workup and B12 status was analysed where available. Results: Of 134 patients, 61 had homocysteine levels, 20 were tested for vitamin B12 (age range 0-14.8 years), 14/20 for MMA. B12 deficiency was found in 7/20 with median age of acute stroke presentation of 1 day (25th percentile= 0; 75th percentile= 51days). Median age of stroke presentation in B12 replete group was 3.5 years (25th percentile=2.0;75th percentile=7.0years). There was a statistical difference in age of stroke presentation between the B12 deficient and replete groups (Kruskal-Wallis, p=0.001). Raised homocysteine (10/20) was not sensitive in detecting B12 deficiency (sensitivity 42.8%, 95% CI 15.82-74.95). Two of seven had additional risk factors (1/7 iron deficiency, 1/7 MTHFR 667 homozygous). Seizures were the most common stroke presentation regardless of B12 status. Vitamin B12 (im) was given in 4/7 children and 3/9 parents (2 mothers, 1 father). Five of seven were breast fed. All treated parents were vegetarian. Conclusion: Our study suggests vitamin B12 deficiency is associated with early childhood stroke. Homocysteine alone is not a sensitive screen for this. Investigation with functional biomarkers such as holo B12 and MMA would allow for improved detection of a treatable risk factor in childhood stroke. Further studies may support this recommendation being added to guidelines.


2008 ◽  
Vol 14 (2) ◽  
pp. 217-223 ◽  
Author(s):  
Peggy D. Headstrom ◽  
Stephen J. Rulyak ◽  
Scott D. Lee

Author(s):  
Amer Abu-Shanab ◽  
Malek Zihlif ◽  
Momen N. Rbeihat ◽  
Zakaria W. Shkoukani ◽  
Alia Khamis ◽  
...  

Objective: To explore (a) the risk factors associated with a deficiency of vitamin B12, and (b) the baseline (cutoff) serum level of vitamin B12 for a clinically-symptomatic deficiency in the Jordanian adult population. Background: Compared to the data available for developed countries, there is a marked scarcity of information on the levels and symptomology of vitamin B12 deficiency in developing countries, particularly in the Middle Eastern region. Methods: A total of 485 subjects were included in this study. Blood samples were drawn for biochemical analysis and data regarding socio-demographics, general health, anthropometric measures, and past medical, surgical, and medication history were collected. To explore the cut-off point, we compared all parameters included in a standard complete blood count as well as main symptoms reported to be associated with B12 deficiency between groups of different B12 cut-off values, consisting of those above and below 200, 175, 150 and 125 pg/ml. Results: Dietary habits, age, recurrent headaches, heart burn and peptic ulcer disease were found to be significantly associated with lower vitamin B12 levels. Surprisingly, daily smoking was associated with significantly higher B12 levels. The results revealed that none of the included potential indicators of B12 deficiency could be considered an indicative feature of deficiency. There were no significant differences neither in the symptoms nor in the CBC parameters between any of the tested study groups. Conclusion: Low dietary intake, older ages, recurrent headaches, heartburn and peptic ulcer disease, all could be considered as a risk factors of having low vitamin B12 levels within the Jordanians. Also, they tend to have lower levels of vitamin B12 levels, in comparison to countries in the West, without necessarily having deficiency symptoms. Cut-off value to diagnose functional B12 deficiency could be less than 125 pg/ml for the Jordanians. More local studies are needed to establish an accurate vitamin B12 cut-off value for the population in Jordan.


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