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Vitamin B12 deficiency: interesting datas for the hematologist Volume 13, issue 3, Mai-Juin 2007

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Service de médecine interne, diabète et maladies métaboliques, Clinique médicale B, Hôpital civil, Hôpitaux universitaires de Strasbourg, 1 place de l’Hôpital, 67091 Strasbourg, France, Service de médecine interne et gériatrie, Hôpital de la Robertsau, Hôpitaux universitaires de Strasbourg, France, Département d’oncologie et hématologie, Hôpital civil, Hôpitaux universitaires de Strasbourg, France

During last decades, substantial progresses have been recorded in the diagnosis of cobalamin (vitamin B12) deficiency. Routine use of cobalamin-standardized assays has potentially modified the frequency and the type of hematologic abnormalities. Current studies on cobalamin deficiency, including more precise definitions and the description of new causes of cobalamin deficiency in adults, as the food-cobalamin malabsorption syndrome, show that hematological abnormalities are generally incomplete compared to historical descriptions of megaloblastic anemia. Nevertheless, they include severe manifestations in 10 % of the patients: pancytopenia, severe anemia or hemolytic anemia and pseudo thrombotic microangiopathy related to cobalamin deficiency. These studies also show the efficacy of new treatment modalities including oral cobalamin administration.