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Cobalamin and unsaturated transcobalamin values in pernicious anaemia: Relation to treatment
Author(s) -
Magnus Erik M.
Publication year - 1986
Publication title -
scandinavian journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 84
eISSN - 1600-0609
pISSN - 0036-553X
DOI - 10.1111/j.1600-0609.1986.tb02281.x
Subject(s) - cobalamin , medicine , pernicious anaemia , vitamin b12 , vitamin , intrinsic factor , vitamin b , endocrinology , gastroenterology
27 patients with pernicious anaemia, followed for a long period, were consecutively treated with 3 different vitamin B 12 preparations while, during intervening periods, no therapy was given until signs of B 12 deficiency developed. The mean of the vitamin B 12 ‐free period lasted 400 d. Some patients were ‘short‐reactors’ whereas others were ‘long‐reactors’. Some patients repeatedly revealed deficiency signs at cobalamin values > 200 pmol/l and others at values < 50 pmol/l, pointing to individually different cutoff points for appearance of signs of deficiency. Hypersegmentation was the first sign in about 2/3, neuropathy in 1/3 and mucosal changes in about 1/10 of the patients. The same type of deficiency was repeatedly noted in the same patient. The daily decline of plasma cobalamin values decreased during the vitamin B 12 ‐free period. In perorally treated patients the unsaturated transcobalamin values showed an inverse relationship to the cobalamin values. Marked increases in unsaturated transcobalamin I values were noted in 4 of 16 patients treated with B 12 injections, resulting in prolonged high cobalamin values and prolongation of the vitamin B 12 ‐free periods.