Elevated serum vitamin B12 concentrations in a patient with pancreatic exocrine insufficiency.

IF 2.1 4区 医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL Biomarkers in medicine Pub Date : 2025-02-01 Epub Date: 2025-01-25 DOI:10.1080/17520363.2025.2455927
Richard Makins, Emma Stevenson, Agata Sobczyńska-Malefora
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Abstract

This case describes a patient with pancreatic exocrine insufficiency and persistently elevated serum vitamin B12 concentrations that were not due to supplementation or associated with hepatic or hematological pathology. Laboratory investigations suggested the presence of macro-B12 as the cause of this patient's raised serum vitamin B12. Macro-B12 is often formed when vitamin B12-vitamin binding proteins (transcobalamin and haptocorrin) complex with immunoglobulins. These molecules are thought to be biologically inert but their presence may lead to unnecessary investigations trying to eliminate other causes of elevated serum vitamin B12, such as solid tumors or hematological malignancies. If the presence of macro-B12 is suspected, the functional markers of B12 status, methylmalonic acid (MMA) or homocysteine, may be used preferentially to serum vitamin B12 to assess status.

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胰腺外分泌功能不全患者血清维生素B12浓度升高。
本病例描述了一个胰腺外分泌功能不全和血清维生素B12浓度持续升高的患者,这不是由于补充或与肝脏或血液病理学相关。实验室调查显示,大量维生素B12的存在是该患者血清维生素B12升高的原因。当维生素b12 -维生素结合蛋白(转钴胺素和接触蛋白)与免疫球蛋白结合时,通常形成大量的b12。这些分子被认为是生物惰性的,但它们的存在可能导致不必要的调查,试图消除血清维生素B12升高的其他原因,如实体瘤或血液系统恶性肿瘤。如果怀疑存在大量B12, B12状态的功能标记物,甲基丙二酸(MMA)或同型半胱氨酸,可以优先使用血清维生素B12来评估状态。
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来源期刊
Biomarkers in medicine
Biomarkers in medicine 医学-医学:研究与实验
CiteScore
3.80
自引率
4.50%
发文量
86
审稿时长
6-12 weeks
期刊介绍: Biomarkers are physical, functional or biochemical indicators of physiological or disease processes. These key indicators can provide vital information in determining disease prognosis, in predicting of response to therapies, adverse events and drug interactions, and in establishing baseline risk. The explosion of interest in biomarker research is driving the development of new predictive, diagnostic and prognostic products in modern medical practice, and biomarkers are also playing an increasingly important role in the discovery and development of new drugs. For the full utility of biomarkers to be realized, we require greater understanding of disease mechanisms, and the interplay between disease mechanisms, therapeutic interventions and the proposed biomarkers. However, in attempting to evaluate the pros and cons of biomarkers systematically, we are moving into new, challenging territory. Biomarkers in Medicine (ISSN 1752-0363) is a peer-reviewed, rapid publication journal delivering commentary and analysis on the advances in our understanding of biomarkers and their potential and actual applications in medicine. The journal facilitates translation of our research knowledge into the clinic to increase the effectiveness of medical practice. As the scientific rationale and regulatory acceptance for biomarkers in medicine and in drug development become more fully established, Biomarkers in Medicine provides the platform for all players in this increasingly vital area to communicate and debate all issues relating to the potential utility and applications. Each issue includes a diversity of content to provide rounded coverage for the research professional. Articles include Guest Editorials, Interviews, Reviews, Research Articles, Perspectives, Priority Paper Evaluations, Special Reports, Case Reports, Conference Reports and Company Profiles. Review coverage is divided into themed sections according to area of therapeutic utility with some issues including themed sections on an area of topical interest. Biomarkers in Medicine provides a platform for commentary and debate for all professionals with an interest in the identification of biomarkers, elucidation of their role and formalization and approval of their application in modern medicine. The audience for Biomarkers in Medicine includes academic and industrial researchers, clinicians, pathologists, clinical chemists and regulatory professionals.
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