Abstract:

The variable clinical signs of megaloblastic anemia associated with cobalamin deficiency and the existence of laboratory findings cause difficulties in diagnosis. Although it was noted that the reduction of serum holotranskobalamin II (holoTC II) levels was a early mark in the diagnosis of cobalamin deficiency, a method suitable for clinical use has not been developed. This study aimed at comparing the effectiveness of holoTC II RIA (Radioimmune Assay), a new commercial test to determine the cobalamin deficiency, with other laboratory findings. At the time of application, 14 of 20 patients (70%) found anemia and macrositosis, nine (45%) trombocytopene, seven (35%) neutropene, 10 (50%) serum cobalamin levels (<100 pg/mL) and 19 (95%) holoTC II levels (<37 pmol/L) low. A statistically significant increase in the hemoglobin, hematokrit, thrombocytes, serum kobalamin and serum holoTC II values compared to pre-treatment after 1 mg/day of cianocobalamin was observed (P<0.05). The MCV, LDH and indirect bilirubin values were reduced (P<0.05). It was found that plasma holoTC II level measurements had higher specificity and sensitivity in determining cobalamin deficiency.

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