scholarly journals Macro-B12 masking B12 deficiency

2022 ◽  
Vol 15 (1) ◽  
pp. e247660
Author(s):  
Bruce H R Wolffenbuttel ◽  
Anneke C Muller Kobold ◽  
Agata Sobczyńska‐Malefora ◽  
Dominic J Harrington
Keyword(s):  
Clinical Practice ◽  
Complex Formation ◽  
Young Woman ◽  
Liver Diseases ◽  
Binding Proteins ◽  
Elevated Serum ◽  
Neurologic Symptoms ◽  
Upper Limit ◽  
Oral Form ◽  
B12 Deficiency

In clinical practice, the finding of an elevated serum B12 concentration is often the consequence of supplementation with B12 in either oral form or injections. Also, elevated serum B12 may be associated with underlying disorders, like liver diseases or a (haematologic) malignancy. Only a few studies have shown that it may also be the consequence of complex formation of B12-vitamin binding proteins with immunoglobulins, the so-called macro-B12. We describe a young woman who previously was diagnosed with B12 deficiency, and in whom, after cessation of B12 injection treatment, neurologic symptoms re-appeared, and despite this, repeatedly elevated serum B12 concentrations above the upper limit of the assay were found. We demonstrated that this was caused by the presence of macro-B12, which not only resulted in erroneous and longstanding elevated serum B12, but also masked her underlying B12 deficiency.

The miR-21 potential of serving as a biomarker for liver diseases in clinical practice

2020 ◽  
Vol 48 (5) ◽  
pp. 2295-2305
Author(s):  
Jiawei Zhang ◽  
Dandan Li ◽  
Rui Zhang ◽  
Peng Gao ◽  
Rongxue Peng ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Liver Diseases ◽  
Hepatic Disease ◽  
Noninvasive Detection ◽  
Diagnosis And Prognosis ◽  
Expected Performance ◽  
Potential Biomarker ◽  
Disease Condition ◽  
Complex Regulatory Network

The role of miR-21 in the pathogenesis of various liver diseases, together with the possibility of detecting microRNA in the circulation, makes miR-21 a potential biomarker for noninvasive detection. In this review, we summarize the potential utility of extracellular miR-21 in the clinical management of hepatic disease patients and compared it with the current clinical practice. MiR-21 shows screening and prognostic value for liver cancer. In liver cirrhosis, miR-21 may serve as a biomarker for the differentiating diagnosis and prognosis. MiR-21 is also a potential biomarker for the severity of hepatitis. We elucidate the disease condition under which miR-21 testing can reach the expected performance. Though miR-21 is a key regulator of liver diseases, microRNAs coordinate with each other in the complex regulatory network. As a result, the performance of miR-21 is better when combined with other microRNAs or classical biomarkers under certain clinical circumstances.

Use of CA-125 to Define Progression of Ovarian Cancer in Patients With Persistently Elevated Levels

2001 ◽  
Vol 19 (20) ◽  
pp. 4054-4057 ◽  
Author(s):  
Gordon J.S. Rustin ◽  
Maria Marples ◽  
Ann E. Nelstrop ◽  
Mohamed Mahmoudi ◽  
Tim Meyer
Keyword(s):  
Ovarian Cancer ◽  
Clinical Trials ◽  
Myocardial Infarct ◽  
Elevated Serum ◽  
Epithelial Ovarian Carcinoma ◽  
Ca 125 ◽  
Clinical Progression ◽  
False Positive Prediction ◽  
Upper Limit ◽  
Accurate Definition

PURPOSE: To determine an accurate definition for progression of ovarian cancer in patients with a persistently elevated serum CA-125. PATIENTS AND METHODS: A retrospective analysis was performed on 300 patients with epithelial ovarian carcinoma with at least one measurement of CA-125. The date of progression according to clinical or radiologic criteria was ascertained in the 88 patients with persistently elevated CA-125 levels (> 23 U/mL). This was compared with the date of progression according to CA-125, defined as the date on which the CA-125 level first increased to ≥ twice its nadir level, confirmed by a second sample also ≥ twice the nadir. RESULTS: Eighty of the 88 patients had evidence of progression by both standard and CA-125 criteria, giving a sensitivity of 94%. In six of these patients, no sample was taken to confirm CA-125 doubling. In 13 patients, CA-125 doubling occurred after the date of clinical progression. Only one patient had a false-positive prediction of progression according to CA-125; the patient died as a result of a myocardial infarct before evidence of clinical progression. CONCLUSION: In patients whose CA-125 level decreases to normal after chemotherapy, a doubling from the upper limit of normal has been shown to predict progression. In those with persistently elevated levels, doubling of CA-125 from its nadir level has now been shown to accurately define progression. If confirmed, these CA-125 criteria should be used as additional end points in clinical trials.

Upper limit of urea complex formation with n-heptane in the presence of n-1-heptene

1975 ◽  
Vol 11 (2) ◽  
pp. 97-98
Author(s):  
T. A. Volkova ◽  
I. D. Makhinya ◽  
A. I. Bogatova ◽  
V. A. Matishev
Keyword(s):  
Complex Formation ◽  
Urea Complex ◽  
Upper Limit

scholarly journals Can serum ferritin levels predict the severity of dengue early?: an observational study

2019 ◽  
Vol 7 (3) ◽  
pp. 876
Author(s):  
Velammal Petchiappan ◽  
Thaha Mohammed Hussain ◽  
Saravanan Thangavelu
Keyword(s):  
Platelet Count ◽  
Clinical Practice ◽  
Observational Study ◽  
Hospital Stay ◽  
Serum Ferritin ◽  
Early Recognition ◽  
Dengue Infection ◽  
Elevated Serum ◽  
Severe Dengue ◽  
Elderly Subjects

Background: Dengue infection is a major public health threat; early recognition is crucial to improve the survival in severe dengue. Although there are various biomarkers to predict the severity of dengue, they are not routinely used in clinical practice for prognostication. We analyzed whether serum ferritin can be used to predict the severity at an earlier stage.Methods: A hospital based prospective observational study was done involving 119 dengue cases diagnosed by positive NS1 antigen or dengue specific serology (capture ELISA). Serum ferritin was measured in all at the time of diagnosis. Clinical and platelet count monitoring was done daily; classified as severe and non-severe according to 2009 WHO criteria.Results: Out of 119, 5 developed severe dengue; patients with severe dengue had significantly lower median platelet count (p<0.0001); higher ferritin levels (p=0.03) and hospital stay (p<0.0001) than non-severe group. Age had a significant negative co-relation with platelet count (r= -0.427; p<0.0001); positive correlation with ferritin levels (r=0.16; p=0.08) and hospital stay (r= 0.26; p=0.004) indicating that elderly subjects are at risk of severe disease. Serum ferritin levels negatively correlated with the platelet count (r= -0.51 p<0.001). High ferritin levels in severe cases are noted from day 4 of clinical illness.Conclusions: Elevated serum ferritin levels can be used as a potential early prognostic marker to predict the severity of dengue infection in clinical practice.

scholarly journals Hyperferritinemia in patients with nonalcoholic fatty liver disease

2017 ◽  
Vol 63 (3) ◽  
pp. 284-289 ◽  
Author(s):  
Raffaelle K Barros ◽  
Helma Pinchemel Cotrim ◽  
Carla H Daltro ◽  
Yanaihara A Oliveira
Keyword(s):  
Liver Disease ◽  
Fatty Liver ◽  
Nonalcoholic Fatty Liver Disease ◽  
Fatty Liver Disease ◽  
Liver Diseases ◽  
Elevated Serum ◽  
Case Series ◽  
Clinical Approach ◽  
Retrospective Case ◽  
Nonalcoholic Fatty Liver

Summary Objective: In liver diseases, hyperferritinemia (HYF) is related to injured cells in acquired and genetic conditions with or without iron overload. It is frequent in patients with nonalcoholic fatty liver disease (NAFLD), in which it is necessary to define the mean of HYF to establish the better approach for them. The present study evaluated the significance of elevated ferritin in patients with NAFLD and steatohepatitis (NASH). Method: The review was performed using search instruments of indexed scientific material, including MEDLINE (by PubMed), Web of Science, IBECS and LILACS, to identify articles published in Portuguese, English and Spanish, from 2005 to May, 2016. Studies eligible included place and year of publication, diagnose criteria to NAFLD, specifications of serum ferritin measurements and/or liver histopathologic study. Exclusion criteria included studies with patients with alcohol consumption ≥ 20 g/day and other liver diseases. Results: A total of 11 from 30 articles were selected. It included 3,564 patients and they were cross-sectional, retrospective, case series and case-control. The result's analyses showed in 10 of these studies a relationship between ferritin elevated serum levels and NAFLD/NASH with and without fibrosis and insulin resistance. Conclusion: Hyperferritinemia in patients with NAFLD/NASH is associated more frequently with hepatocellular injury than hemochromatosis. These data suggest the relevance to evaluate carefully HYF in patients with NAFLD/NASH to establish appropriate clinical approach.

TRH (Thyroid-Releasing Hormone) Tests

1984 ◽  
Vol 6 (6) ◽  
pp. 189-190
Keyword(s):  
Binding Proteins ◽  
Elevated Serum ◽  
Graves Disease ◽  
Base Line ◽  
Trh Test ◽  
Thyroxine Binding Globulin ◽  
Serum Thyroxine ◽  
Free Thyroxine Index ◽  
Serum T4 ◽  
Line Test

I have read with great interest "Goiter in Children" by Foley (PIR 1984;5:259). The author stated: "In patients with thyromegaly and mild symptoms of hyperthyroidism, a TRH test will help to discriminate hyperthyroxemia secondary to increased or abnormal serum thyroxine binding proteins from early Graves disease, factitious hyperthyroidism, toxic thyroiditis, and TSH-mediated hyperthyroidism." I would suggest the use of a triiodothyronine (T3) resin uptake as a base-line test. An elevated serum thyroxine (T4) value in conjunction with a diminished T3 resin uptake suggests thyroxine-binding globulin (TBG) excess, which can be confirmed by specific quantitation of TBG. Patients with familial dysalbuminemic hyperthyroxinemia (FDH) have elevated levels of serum T4 and free thyroxine index (FT4l) values but normal T3 resin uptake and TBG levels.

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