Objective:
Vitamin B12 deficiency mainly causes megaloblastic anemia and neurological abnormalities. The purpose of the present study was to evaluate the clinical and laboratory features of patients with confirmed vitamin B12 deficiency, retrospectively.
Material and Methods:
Thirty-one patients who were admitted to Department of Internal Medicine of Afyon Kocatepe University Hospital and identified as having vitamin B12 deficiency were enrolled in the study. Data were obtained retrospectively from medical records, including the reason of investigating vitamin B12 levels, comorbidities, concomitant acute infection, hemoglobin level, mean corpuscular volume (MCV), leukocyte and platelet counts, and existence of iron deficiency anemia and folic acid deficiency.
Results:
The mean vitamin B12 level was 138.9±30.7 pg/ml, hemoglobin 9.3±2.0 g/dl, MCV 88.2±11.9 fL. Nine patients had iron deficiency anemia. In patients with iron deficiency anemia, MCV was significantly lower (P=0.041). While nine patients (29%) had acute infection, 3 patients presented with pancytopenia. Pancytopenia was significantly higher in patients with acute infection (P=0.023). The relation between B12 levels and other parameters was investigated. Only MCV levels had negative correlation with vitamin B12 levels (r=-0.450, P=0.011).
Conclusion:
Macrocytosis in our study group has been found to be low in accordance with previous studies. As in our investigation, although vitamin B12 deficiency may be reason for increased MCV, this rise may not always reach levels for macrocytosis. The concomitant iron deficiency anemia may be responsible for this situation. Consequently, vitamin B12 levels have to be investigated in anemic patients, whether MCV is normal or not.
Keywords: vitamin B12 deficiency, macrocytosis, anemia