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CLINICAL SIGNIFICANCE OF ELEVATED SERUM COBALAMIN (VITAMIN B12) LEVELS
Author(s): ,
İnci Yaman Bajin
Affiliations:
Pediatric Hematology,Hacettepe University,Ankara,Turkey
,
Elif Sabancı
Affiliations:
Pediatrics,Hacettepe University,Ankara,Turkey
,
Şule Akyan
Affiliations:
Pediatrics,Hacettepe University,Ankara,Turkey
,
Selin Aytac
Affiliations:
Pediatric Hematology,Hacettepe University,Ankara,Turkey
,
Mualla Çetin
Affiliations:
Pediatric Hematology,Hacettepe University,Ankara,Turkey
Fatma Gümrük
Affiliations:
Pediatric Hematology,Hacettepe University,Ankara,Turkey
(Abstract release date: 05/18/17) EHA Library. Aytac S. 05/18/17; 182800; PB2086
Assoc. Prof. Selin Aytac
Assoc. Prof. Selin Aytac
Contributions
Abstract

Abstract: PB2086

Type: Publication Only

Background
Hypercobalaminemia is a frequent but underestimated abnormality. Elevated serum cobalamin levels may be a sign of a wide range of diseases like solid neoplasms, haematological disorders like myeloproliferative disorders, chronic myelogeneous leukemia, promyelocytic leukemia, polycythemia vera, hypereosinophilic syndrome as well as liver and kidney diseases.

Aims
We aimed to evaluate the underlying disorders of the patients with high cobalamine levels (>1000 pmol/l) between 01.02.2016- 01.02.2017 in Hacettepe University Pediatric Hematology Department.

Methods
We investigated the patient records of the patients examined between 01.02.2016- 01.02.2017 in our department and included the patients with serum cobalamine levels higher than 1000 pmol/l. We excluded the patients who are taking Vitamin B12 supplement.

Results
There were 46 patients with serum cobalamine levels higher than 1000 pmol/l out of 14367 patients seen between 01.02.2016- 01.02.2017 in our department. The reason to check the cobalamin levels were anemia, neutropenia and thrombocytopenia in most of the patients. Only 2 patients were referred to our department because of hypercobalaminemia. The underlying disorders were found to be leukemia in 3 patient ( Acute lymphoblastic leukemia (ALL) n:1, acute myeloblastic leukemia (AML) n:1 , large granular lymphocytic leukemia (LGLL) n:1), myelodisplastic syndrome (MDS) in 2 patients, isolated thrombocytopenia in 4 patients, isolated neutropenia in 7 patients, bicytopenia in 4 patients and aplastic anemia in 2 patients, cobalamine metabolism defects in 10 patients, hypereosinophilia in 2 patients, polisitemia in 1 patient, cystic fibrosis in 1 patient, HIV in 1 patient, FMF (familial mediterrenian fever) in 1 patient, chronic kidney failure in 2 patients, sickle cell anemia in 1 patient, factor 7 deficiency in 1 patient, thrombosis in 1 patient and epistaxis in 1 patient.

Conclusion
An observed elevation of cobalamin merits the a full diagnostic work up to assess the presence of an early diagnostic marker of these diseases. When we look at the patients except hematological neoplasm and cytopenias, most of the underlying reasons is associated with inflamation and infection, cobalamin was found to be elevated as an acute fase reactant. A certain approach is needed whether to determine the potential indications to search for high serum cobalamin levels and to determine the practical clinical strategy when elevated cobalamin levels discovered.

Session topic: 31. Other Non-malignant hematopoietic disorders

Keyword(s): Homocysteine, Children, Methylmalonic acid

Abstract: PB2086

Type: Publication Only

Background
Hypercobalaminemia is a frequent but underestimated abnormality. Elevated serum cobalamin levels may be a sign of a wide range of diseases like solid neoplasms, haematological disorders like myeloproliferative disorders, chronic myelogeneous leukemia, promyelocytic leukemia, polycythemia vera, hypereosinophilic syndrome as well as liver and kidney diseases.

Aims
We aimed to evaluate the underlying disorders of the patients with high cobalamine levels (>1000 pmol/l) between 01.02.2016- 01.02.2017 in Hacettepe University Pediatric Hematology Department.

Methods
We investigated the patient records of the patients examined between 01.02.2016- 01.02.2017 in our department and included the patients with serum cobalamine levels higher than 1000 pmol/l. We excluded the patients who are taking Vitamin B12 supplement.

Results
There were 46 patients with serum cobalamine levels higher than 1000 pmol/l out of 14367 patients seen between 01.02.2016- 01.02.2017 in our department. The reason to check the cobalamin levels were anemia, neutropenia and thrombocytopenia in most of the patients. Only 2 patients were referred to our department because of hypercobalaminemia. The underlying disorders were found to be leukemia in 3 patient ( Acute lymphoblastic leukemia (ALL) n:1, acute myeloblastic leukemia (AML) n:1 , large granular lymphocytic leukemia (LGLL) n:1), myelodisplastic syndrome (MDS) in 2 patients, isolated thrombocytopenia in 4 patients, isolated neutropenia in 7 patients, bicytopenia in 4 patients and aplastic anemia in 2 patients, cobalamine metabolism defects in 10 patients, hypereosinophilia in 2 patients, polisitemia in 1 patient, cystic fibrosis in 1 patient, HIV in 1 patient, FMF (familial mediterrenian fever) in 1 patient, chronic kidney failure in 2 patients, sickle cell anemia in 1 patient, factor 7 deficiency in 1 patient, thrombosis in 1 patient and epistaxis in 1 patient.

Conclusion
An observed elevation of cobalamin merits the a full diagnostic work up to assess the presence of an early diagnostic marker of these diseases. When we look at the patients except hematological neoplasm and cytopenias, most of the underlying reasons is associated with inflamation and infection, cobalamin was found to be elevated as an acute fase reactant. A certain approach is needed whether to determine the potential indications to search for high serum cobalamin levels and to determine the practical clinical strategy when elevated cobalamin levels discovered.

Session topic: 31. Other Non-malignant hematopoietic disorders

Keyword(s): Homocysteine, Children, Methylmalonic acid

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