Cobalamin Deficiency Can Mask Depleted Body Iron R

Authors: Soner Solmaz Hakan Özdoğu Can Boğa

Publish Date: 2014/06/14

Volume: 31, Issue: 2, Pages: 255-258

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Abstract

Vitamin B12 deficiency impairs DNA synthesis and causes erythroblast apoptosis resulting in anaemia from ineffective erythropoiesis Iron and cobalamin deficiency are found together in patients for various reasons We have observed that cobalamin deficiency masks iron deficiency in some patients We hypothesised that iron is not used by erythroblasts because of ineffective erythropoiesis due to cobalamin deficiency Therefore we aimed to demonstrate that depleted iron body reserves are masked by cobalamin deficiency Seventyfive patients who were diagnosed with cobalamin deficiency were enrolled in this study Complete blood counts and serum levels of iron unsaturated iron binding capacity UIBC ferritin vitamin B12 and thyroid stimulant hormone were determined at diagnosis and after cobalamin therapy Patients who had a combined deficiency at diagnosis and after cobalamin therapy were recorded Before cobalamin therapy we found increased serum iron levels 1264 ± 634 µg/dL decreased serum UIBC levels 1437 ± 708 µg/dL increased serum ferritin levels 1925 ± 1164 ng/mL and increased transferrin saturation values 472 ± 235  After cobalamin therapy serum iron levels 591 ± 30 µg/dL serum ferritin levels 449 ± 389 ng/mL and transferrin saturation values 175 ± 96  decreased and serum UIBC levels 2959 ± 806 µg/dL increased Significant differences were observed in all values p  00001 Seven patients 93  had iron deficiency before cobalamin therapy 37 493  had iron deficiency after cobalamin therapy and a significant difference was detected between the proportions of patients who had iron deficiency p  00001 This study is important because insufficient data are available on this condition Our results indicate that iron deficiency is common in patients with cobalamin deficiency and that cobalamin deficiency can mask iron deficiency Therefore we suggest that all patients diagnosed with cobalamin deficiency should be screened for iron deficiency particularly after cobalamin therapy

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