scholarly journals Pancytopenia in pregnant patients with COVID-19 infection and vitamin B12 deficiency: a case report study

2021 ◽  
Vol 4 (Special2) ◽  
pp. 415-418
Author(s):  
Neha Agarwal ◽  
Neha Khatri ◽  
Preeti Singh
Keyword(s):  
Folic Acid ◽  
Vitamin B12 ◽  
Vitamin B12 Deficiency ◽  
Vitamin B ◽  
Case Presentation ◽  
B12 Deficiency ◽  
Vitamin B 12 ◽  
Folate And Vitamin B12 ◽  
Vitamin B12 Supplementation ◽  
In Pregnancy

Background: Folate and vitamin B 12 deficiency can lead to pancytopenia in pregnancy. Some cases of pancytopenia due to COVID-19 infection have also been reported. The two cases that we present are related to the coincidence of pregnancy and deficiency of folic acid and vitamin B12 with COVID-19 infection. Case presentation: A 26-year- woman G3P1L1A1 and 21-year-woman G2P1L1 presented with pancytopenia and mild COVID-19 infection. The antenatal period was uneventful, and both cases also had folate and vitamin B12 deficiency. They received blood products, folic acid, and vitamin B12 supplementation. COVID- 19 infection was managed well with analgesic and vital monitoring. Postpartum hemorrhage occurred in the second case, which was well managed with uterotonics. All laboratory parameters came out to be normal after three months of supplementation of folic acid and vitamin B12. Conclusion: Pancytopenia in pregnancy due to folate and vitamin B12 deficiency and COVID- 19 infection can be easily managed with timely intensive targeted therapy, but we should be extra vigilant while handling such complicated cases, keeping in mind all possible differential diagnoses for pancytopenia.

scholarly journals Homocystinuria masquerading as vitamin B12 deficiency

2012 ◽  
Vol 4 (2) ◽  
pp. 326-328
Author(s):  
M Wadhwani ◽  
S Beri ◽  
A Saili ◽  
S Garg
Keyword(s):  
Vitamin B12 ◽  
Megaloblastic Anemia ◽  
Vitamin B12 Deficiency ◽  
Interesting Case ◽  
Vitamin B ◽  
Ophthalmological Examination ◽  
Ophthalmic Manifestations ◽  
History Of ◽  
B12 Deficiency ◽  
Vitamin B 12

Background: Homocystinuria is a rare metabolic disorder charcterised by excess homocysteine in the urine. Vitamin B12 deficiency has diverse cutaneous, nervous and ophthalmic manifestations. Objective: To report a case of homocystinuria masquerading as vitamin B 12 deficiency. Case: We hereby are presenting an interesting case of a 4 year old boy who was being treated for Vitamin B 12 deficiency on the basis of history of delayed milestone, abdominal pain and hyperpigmentation of skin which was diagnosed as homocystinuria. Conclusion: It is important to carry out ophthalmological examination in every case of megaloblastic anemia if associated with blurring of vision and mental retardation.DOI: http://dx.doi.org/10.3126/nepjoph.v4i2.6554 Nepal J Ophthalmol 2012; 4 (8): 326-328

scholarly journals Vitamin B 12 Assay – are we on Track?

2020 ◽  
Vol 2 (8) ◽  
pp. 01-03
Author(s):  
Rateesh Sareen
Keyword(s):  
Vitamin B12 ◽  
Vitamin B12 Deficiency ◽  
Reference Interval ◽  
Population Characteristics ◽  
Vitamin B ◽  
B12 Deficiency ◽  
Vitamin B 12 ◽  
Work Up

Vitamin B12 assay is one of the most frequently ordered tests particularly as a part of regular medical checkups. The deficiency is rampant in vegetarian population. It is of immense importance that laboratories establish their own reference interval (RI) of analyte specially Vitamin B12 as a diagnosis of Vitamin B12 deficiency based on RI of kit insert inadvertently leads to unnecessary treatment or work up. A blind reliance on RI of kit insert should be discouraged as they do not take into account population characteristics and do not truly reflect RI specific to the population under study.

scholarly journals Questionable Reliability Of Homocysteine As The Metabolic Marker For Folate And Vitamin B12 Deficiency In Patients With Chronic Obstructive Pulmonary Disease

2015 ◽  
Vol 34 (4) ◽  
pp. 467-472 ◽  
Author(s):  
Anđelo Beletić ◽  
Duško Mirković ◽  
Aleksandra Dudvarski-Ilić ◽  
Branislava Milenković ◽  
Ljudmila Nagorni-Obradović ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Vitamin B12 ◽  
Vitamin B12 Deficiency ◽  
Chronic Obstructive ◽  
Vitamin B ◽  
Obstructive Pulmonary Disease ◽  
Metabolic Marker ◽  
Copd Patients ◽  
B12 Deficiency ◽  
Folate And Vitamin B12

SummaryBackground:An increased homocysteine (Hcy) concentration may represent a metabolic marker of folate and vitamin B12deficiency, both significant public health problems. For different reasons, patients with chronic obstructive pulmonary disease (COPD) are prone to these deficiencies. The study evaluates the reliability of Hcy concentration in predicting folate or vitamin B12deficiency in these patients.Methods:A group of 50 COPD patients (28 males/22 females, age$({\rm{\bar x}} \pm {\rm{SD}} = 49.0 \pm 14.5)$years was enrolled. A chemiluminescent microparticle immunoassay was applied for homocysteine, folate and vitamin B12concentration. Kolmogorov-Smirnov, Mann-Whitney U and χ2tests, Spearman’s correlation and ROC analysis were included in the statistical analysis, with the level of significance set at 0.05.Results:Average (SD) concentrations of folate and vitamin B12were 4.13 (2.16) μg/L and 463.6 (271.0) ng/L, whereas only vitamin B12correlated with the Hcy level (P=−0.310 (R=0.029)). Gender related differences were not significant and only a borderline significant correlation between age and folate was confirmed (R=0.279 (P=0.047)). The incidence of folate and vitamin B12 deficiency differed significantly (P=0.000 and P<0.000 for folate and vitamin B12respectively), depending on the cut-off used for classification (4.4, 6.6 and 8.0 μg/L – folate; 203 and 473 ng/L – vitamin B12). ROC analyses failed to show any significance of hyperhomocysteinemia as a predictor of folate or vitamin B12deficiency.Conclusion:Reliability of the Hcy concentration as a biomarker of folate or vitamin B12depletion in COPD patients is not satisfactory, so their deficiency cannot be predicted by the occurrence of HHcy.

scholarly journals OVERCOMING VITAMIN B12 DEFICIENCY IN VEGAN DIET

2014 ◽  
Vol 04 (01) ◽  
pp. 104-105
Author(s):  
Prassanna Baby ◽  
Keyword(s):  
Vitamin B12 ◽  
Higher Plants ◽  
Vitamin B12 Deficiency ◽  
Vegan Diet ◽  
Vitamin B ◽  
Daily Diet ◽  
B12 Deficiency ◽  
Vitamin B 12 ◽  
Micro Organisms ◽  
Dietary Deficiency

Abstract:Vitamin B12 is a crystalline compound essential to a number of micro-organisms and animals, including humans. So far as is known it is not present in higher plants. Pure vegetarian food is nearly free from vit. B12. It is a nutrient that needs attention in vegan diet. Vegetarians are at risk for vitamin B(12) (B12) deficiency due to suboptimal intake. Dietary deficiency of vitamin B12 due to vegetarianism is increasing and causes hyperhomocysteinemia Areas for research include intermittent vitamin B12 supplement dosing and better measurements of the bioavailability of B12 in fermented vegetarian foods and algae. The goal of the present literature review was to create an awareness among the vegans to identify the vegetarian sources of Vitamin B12 and to incorporate them into their daily diet.

scholarly journals Severe Anaemia during Late Pregnancy

2012 ◽  
Vol 2012 ◽  
pp. 1-3 ◽  
Author(s):  
Mahenaz Akhtar ◽  
Ismail Hassan
Keyword(s):  
Vitamin B12 ◽  
Vitamin B12 Deficiency ◽  
Late Pregnancy ◽  
Severe Anaemia ◽  
Blood Transfusions ◽  
Deficiency Anaemia ◽  
History Of ◽  
B12 Deficiency ◽  
Folate And Vitamin B12 ◽  
In Pregnancy

Vitamin B12 deficiency is uncommon in pregnancy, it occurs in 10–28% of uncomplicated pregnancies, and is associated with a few complications. We present a case report of a 21-year-old patient with severe anaemia during late pregnancy caused by vitamin B12 deficiency. At 38 weeks gestation and with a BMI of 48.9, a history of rupture of membranes was given but not confirmed. On examination, she appeared pale and therefore full blood counts were done. Interestingly her haemoglobin (Hb) levels were 3.7 g/dL. Folate and vitamin B12 levels were also found to be low, and the diagnosis of anaemia caused by vitamin B12 deficiency was made. After treatment with vitamin B12 injections, folic acid and blood transfusions, the patient’s haemoglobin levels improved from 3.7 g/dL to 10.7 g/dL. The conclusion is that effective history taking, diagnosis, and management can prevent many complications that are usually associated with vitamin B12 deficiency anaemia.

scholarly journals KNUCKLE HYPERPIGMENTATION AS A PRELIMINARY MARKER OF VITAMIN B 12 DEFICIENCY: A CASE SERIES

2021 ◽  
pp. 36-38
Author(s):  
Manali Patil ◽  
S. N. Agrawal ◽  
V. V. Saoji
Keyword(s):  
Vitamin B12 ◽  
Megaloblastic Anemia ◽  
Case Series ◽  
Vitamin B12 Deficiency ◽  
Neurological Deficits ◽  
Vitamin B ◽  
Important Clue ◽  
B12 Deficiency ◽  
Systemic Manifestations ◽  
Vitamin B 12

Vitamin B12 deficiency is common in vegetarian population in India and can present with variable Hematological (megaloblastic anemia), Neuropsychiatric, Mucocutaneous (glossitis, angular stomatitis), Skin (pallor, hyperpigmentation) and Hair changes (dry, brittle, thin, lustreless, prematurely grey). Knuckle hyperpigmentation has been described in vitamin B12 deficiency but usually these patients are dermatologically asymptomatic but they have systemic manifestations like megaloblastic anemia, pancytopenia or neurological deficits. The foreground of this study is highlighting the importance of knuckle hyperpigmentation as an early cutaneous sign of vitamin B12 deficiency which points an important clue towards the aetiology of Megaloblastic anemia.

scholarly journals Vitamin B12 deficiency among vegetarian and non-vegetarian diabetic population receiving prolonged Metformin based oral hypoglycemic agents therapy

2017 ◽  
Vol 4 (4) ◽  
pp. 1150 ◽  
Author(s):  
Vivek Kumar Verma ◽  
Ranjit Kumar Nim ◽  
P. S. Singh ◽  
Manoj Kumar ◽  
Geeta Singh ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Vitamin B12 ◽  
Vitamin B12 Deficiency ◽  
Animal Origin ◽  
P Value ◽  
Vitamin B ◽  
B12 Deficiency ◽  
Diabetic Population ◽  
Vitamin B 12 ◽  
Diabetes Patients

Background: Diabetes is a group of metabolic disorder that share the phenotype of hyperglycemia. Over the period of time the metabolic dysregulation associated with diabetes mellitus causes secondary pathophysiological changes in multiple organs like heart, blood vessels, eyes, kidney and nerves resulting in various complications. However, a common potential interaction of metformin with vitamin B-12 is well documented but is poorly studied by the physicians who prescribe metformin to their diabetic patients. Since vitamin B-12 deficiency is common among vegan population as compared to population consuming food of animal origin (meat, fish and dairy products). But in this article, it has been studied that metformin cause vitamin B-12 deficiency even in non-vegetarian population. The aim of this study was to asses’ vitamin B12 deficiency among vegetarian and non-vegetarian diabetic population receiving prolonged Metformin based oral hypoglycaemic agents therapy. It was a cross sectional study done in Department of Medicine, UPUMS, Saifai, Etawah, Uttar Pradesh, India.Methods: Study done among patients of type 2 diabetes mellitus of age group 30-60 years on prolonged metformin based OHA therapy and having peripheral neuropathy were included in study. Data was analysed on SPSS Version 22.0 and p value obtained.Results: Statistical analysis of 93 patients included in study showed that vitamin B12 deficiency is common among the vegetarian (56.52%) and non-vegetarian (35.71%) population but the difference is not statistically significant (p value=0.29) which is more in favour of metformin associated vitamin B12 deficiency in non-vegetarian population.Conclusions: Vitamin B12 deficiency is common in diabetes patients on metformin based OHA therapy hence we recommend routine screening for Vitamin B12 deficiency in such diabetes patients. 

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