An investigation of vitamin B12 deficiency in elderly inpatients in neurology department

Abstract

Objective To investigate the status of vitamin B12 deficiency in elderly inpatients in the department of neurology.Methods A total number of 827 patients in the department of neurology of Shanghai Punan hospital, from March 2007 to July 2008, were employed in the present study. They were 60 years or older, and the average age was 77.1±7.5 years old. All the patients were diagnosed with no severe hepatic or renal dysfunction, without any usage of vitamin B12 during the previous 3 months before the detection. The levels of serum vitamin B12, folate and homocysteine (Hcy) were evaluated. The patients with vitamin B12 deficiency were screened. The resulting symptoms, positive signs of neurological examination, and the neuroelectricphysiological results were compared between patients with or without vitamin B12 deficiency. Results Vitamin B12 deficiency was found in 163 patients (19.71% of the total patients), and was more prevalent in female than in male patients, also with increased incidences with aging. Patients with low levels of serum vitamin B12 exhibited higher rate of gastrointestinal diseases, while only 9.82% of the vitamin B12 deficient patients had megaloblastic anemia. Symptoms of vitamin B12 deficiency included unsteadily walking in the darkness and hypopallesthesia, and some chronic diseases such as cerebral ischemia, hypertension, Parkinson's disease (Parkinsonism), diabetes mellitus and coronary heart disease. Most of the vitamin B12 deficient patients had neuroelectricphysiological abnormalities. Conclusion Vitamin B12 deficiency is remarkably common in elderly patients in neurology department, with various and atypical clinical manifestations, and the neurological symptoms are more common than megaloblastic anemia symptoms.

Characteristics of anemia in subclinical and overt hypothyroid patients

“…Wang YH. and colleagues found that vitamin B12 deficiency was 19.71% and megaloblastic anemia prevalence was 9.82% in old hospitalized patients in the neurology clinic [16]. However, the prevalence is observed as 1.6% to 10% in Europe [17].…”

Vitamin B12 deficiency: an unusual cause of vocal fold palsy

“…Vitamin B 12 deficiency is a common condition, and its increasing prevalence is attributed to an ageing population. 1 Deficiency of vitamin B 12 leads to defective DNA synthesis and disrupted megaloblastic maturation, as well as defective production of choline and cholinecontaining phospholipids. These elements are of importance when considering the pathophysiology of vitamin B 12 deficiency.…”

“…The pathophysiology of the neurological process begins with demyelination of the nerves, followed by axonal degeneration and, eventually, irreversible damage due to axonal death. 1 Vocal fold palsies are relatively common in otolaryngological practice; however, vitamin B 12 deficiency is an incredibly rare cause. Despite this, it is important to consider this aetiology, as speedy identification and treatment can help prevent permanent neurological damage.…”

Hydroxocobalamin Quantification in Human Plasma by High-Performance Liquid Chromatography Coupled with Electrospray Tandem Mass Spectrometry in a Pharmacokinetic Study

“…The C max and the time taken to achieve this concentration (T max ) were obtained directly from the curves. The areas under the hydroxocobalamin plasma concentration vs. time curves from 0 to the last detectable concentration (AUC last ) were calculated by applying the linear-log trapezoid rule [9]. Extrapolation of these areas to infinity (AUC 0-inf ) was done by adding the value C last /ke to the calculated AUC last (where C last =the last detectable concentration).…”

“…The differences were present even the dose was corrected by either weight or body surface of the volunteer (Table 5). These pharmacokinetic differences could explain the higher prevalence of vitamin B12 deficiency in female patients [9].…”