Çocuklarda vitamin B12 düzeyleri ile tam kan parametreleri arasındaki ilişkinin değerlendirilmesi

Yıl 2020, Cilt: 10 Sayı: 1, 82 - 85, 31.03.2020

Ömer Kartal , Orhan Gürsel

https://doi.org/10.16899/jcm.691996

Öz

Amaç: Vitamin B12 insan vücudunda üretilemeyen ve sadece hayvansal gıdalar ile alınan bir vitamindir. Vitamin B12 DNA sentezinde önemli rol oynar ve eksikliğinde DNA sentezi bozulur. Sonuç olarak megaloblastik anemi gelişir. Bunun sonucunda psikiyatrik, nörolojik ve hematolojik birçok bozukluk meydana gelebilir. Çalışmamızda kliniğimize başvuran bilinen kronik hastalığı ve herhangi bir kronik ilaç kullanım öyküsü olmayan 2-12 yaş arası hastalarda vitamin B12 düzeyleri ile tam kan parametreleri arasındaki ilişkiyi belirlemeyi amaçladık.
Gereç ve Yöntem: Çalışmaya Ocak 2016 ile Aralık 2019 tarihleri arasında Gülhane Eğitim ve Araştırma Hastanesi çocuk hematolojisi polikliniğine başvuran, vitamin B12 düzeyi bakılmış 2-12 yaş arası 98 hasta dahil edildi. Hastalar vitamin B12 düzeyi normal (vitamin B12 düzeyi ≥200 pg/ml; Grup 1) olan ve vitamin B12 eksikliği (serum vitamin B12 düzeyi <200 pg/ml; Grup 2) olan olarak iki gruba ayrıldı.
Bulgular: Grup 1 ve 2 nin vitamin B12 düzeyi sıra ile 311±43.5; 104.8±15.7 olarak bulundu (p <0.05), (Tablo). Grup 1 ve 2 nin beyaz küre ve trombosit sayıları arasında istatistisel olarak bir fark bulunmadı, sıra ile beyaz küre sayıları 7.6±4.1; 6.9±3.5, sıra ile trombosit sayıları 273.5±74.6; 267.6±95.2 (p >0.05), (Tablo).
Sonuç: Sonuç olarak vitamin B12 eksikliğine toplumumuzda sık olarak karşılaşılmaktadır. Tam kan parametreleri olan beyaz küre, trombosit, RDW, MPV ve MCV değerleri birçok durumda tanıda yeterli olmamaktadır. Vitamin B12 düşüklüğünden şüphelenilen hastalarda mutlaka tanı serum vitamin B12 düzeyi ölçülerek kontrol edilmelidir.

Anahtar Kelimeler

MCV, MPV, RDW, tam kan parametreleri, vitamin B12

Destekleyen Kurum

yok

Evaluation of the relationship between vitamin B12 levels and whole blood parameters in children

Öz

Introduction: Vitamin B12 is a vitamin that can not be produced in the human body, and it could be taken only with animal-sourced foods. Vitamin B12 plays an important role in DNA synthesis, and in its deficiency, DNA synthesis is disrupted. As a result of this, megaloblastic anemia develops. Then later, conditions such as psychiatric, neurological and hematological disorders may occur.
In our study, we aimed to determine the relationship between vitamin B12 levels and whole blood parameters in patients between 2-12 years old who have no known chronic disease, and no history of chronic drug use, who applied to our clinic.
Methods: This study included 98 patients who were evaluated for vitamin B12 level between 2-12 years olds, and it was carried out in Gülhane Training and Research Hospital pediatric hematology clinic between January 2016 and December 2019. The patients were divided into two groups as normal vitamin B12 level (vitamin B12 level ≥200 pg/ml; Group 1) and vitamin B12 deficiency (serum vitamin B12 level <200 pg/ml; Group 2).
Results: Vitamin B12 levels of Group 1 and 2 were found as 311±43.5 and 104.8±15.7, respectively. (p <0.05), (Table). No statistically significant difference was found between white blood cell and platelet counts of groups 1 and 2. White blood cell counts of groups are 7.6±4.1; 6.9±3.5, respectively, and platelet counts of groups are 273.5±74.6; 267.6±95.2, respectively (p >0.05), (Table).
Discussion and Conclusion: As a result, vitamin B12 deficiency is frequently encountered in our society. White blood cells, platelet, RDW, MPV, and MCV values, which are full blood parameters, are not sufficient in diagnosis in many cases. In patients suspected of vitamin B12 deficiency, the diagnosis should be checked by measuring the serum vitamin B12 level.

Anahtar Kelimeler

MCV, MPV, RDW, vitamin B12, whole blood parameters

Kaynakça

• 1. S. Katar. Çocuklarda B12 Vitamin Eksikliği. Dicle Tıp Dergisi 2007;34(1):25–8.
• 2. Gomber S, Kela K, Dhingra N. Clinico-Hematological Profile of Megaloblastic Anemia. Indian Pediatr 1998;35(1):55-8.
• 3. Lu SY, Wu HC. Initial diagnosis of anemia from sore mouth and improved classification of anemias by MCV and RDW in 30 patients. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2004;98(6):679-85.
• 4. Oosterhuis WP, Niessen RW, Bossuyt PM, Sanders GT, Sturk A. Diagnostic value of the mean corpuscular volume in the detection of vitamin B12 deficiency. Scand J Clin Lab Invest 2000;60(1):9-18.
• 5. Bhatia P, Kulkarni JD, Pai SA. Vitamin B12 deficiency in India: Mean corpuscular volume is an unreliable screening parameter. Natl Med J India 2012;25(6):336-8.
• 6. Chan CW, Liu SY, Kho CS, et al. Diagnostic clues to megaloblastic anaemia without macrocytosis. Int J Lab Hematol 2007;29(3):163-71.
• 7. Kondo H. Haematological Effects of Oral Cobalamin Preparations on Patients with Megaloblastic. Acta Haematol 1998;99(4):200-5.
• 8. Green R. Vitamin B12 deficiency from the perspective of a practicing hematologist. Blood 2017;129(19):2603-11.
• 9. Friso S, Udali S, De Santis D, Choi SW. One-carbon metabolism and epigenetics. Mol Aspects Med 2017;54:28-36.
• 10. Koury MJ, Ponka P. New insights into erythropoiesis: the roles of folate, vitamin B12, and iron. Annu Rev Nutr 2004;24:105-31.
• 11. Azimi S, Faramarzi E, Sarbakhsh P, Ostadrahimi A, Somi MH, Ghayour M. Folate and vitamin B12 status and their relation to hematological indices in healthy adults of Iranians: Azar cohort study. Nutr Health 2019;25(1):29-36.
• 12. Abuhandan M, Gümüş H, Solmaz A, Güzel B. Vitamin B12 Eksiliğinde Hastalarda Ortalama Trombosit Volümün Değerlendirilmesi. Journal of Harran University Medical Faculty 2014;11(3):253–6.
• 13. Aktas G, Alcelik A, Tekce BK, Sit M, Savli H, Tekce H. Could Mean Platelet Volume and Red Cell Distribution Width Predict Vitamin Could Mean Platelet Volume and Red Cell Distribution Width Predict Vitamin B12 Deficiency? British Journal of Medicine & Medical Research 2014;4(31):4965-71.
• 14. Castelli MC, Friedman K, Sherry J, et al. Comparing the efficacy and tolerability of a new daily oral vitamin B12 formulation and intermittent intramuscular vitamin B12 in normalizing low cobalamin levels: a randomized, open-label, parallel-group study. Open-Label, Parallel-Group Study. Clin Ther 2011;33(3):358-71.
• 15. Green R, Datta Mitra A. Megaloblastic Anemias Nutritional and Other Causes. Med Clin North Am 2017;101(2):297-317.
• 16. Oberley MJ, Yang DT. Laboratory testing for cobalamin deficiency in megaloblastic anemia. Am J Hematol 2013;88(6):522-6.
• 17. Çolak AA, Anıl M, Toprak B, Köse E, Üstüner F. Çocuklarda B12 vitamin düzeyi ve periferik tam kan sayımı değerleri ile ilişkisi. İzmir Dr. Behçet Uz Çocuk Hast. Dergisi 2012;2(2):75-9.
• 18. Kwok T, Cheng G, Woo J, Lai WK, Pang CP. Independent Effect of Vitamin B 12 Deficiency on Hematological Status in Older Chinese Vegetarian Women. Am J Hematol 2002;70(3):186-90.
• 19. Bor MV, Lydeking-Olsen E, Møller J, Nexø E. A daily intake of approximately 6 microg vitamin B-12 appears to saturate all the vitamin B-12-related variables in Danish postmenopausal women. Am J Clin Nutr 2006;83(1):52-8.
• 20. Stabler SP. Vitamin B 12 Deficiency. N Engl J Med 2013;368(2):149-60.
• 21. Carmel R. How I treat How I treat cobalamin (vitamin B12) deficiency. Blood 2008;112(6):2214-21.
• 22. Schneede J, Ueland PM. Novel and Established Markers of Cobalamin Deficiency: Complementary or Exclusive Diagnostic Strategies. Semin Vasc Med 2005;5(2):140-55.