Journal of Applied Medical Sciences

A Rare Case of Unexpected High Plasma Vitamin B12 levels: A Case Report

• [ Download ]
• Times downloaded: 138

• Abstract

   

  High blood levels of vitamin B12 are often attributed to over-supplementation; however, elevated B12 levels can occur without supplementation, raising concerns about underlying serious conditions. This case report presents a 30-year-old female referred due to high serum cobalamin levels initially discovered during an evaluation for joint pain. Despite no vitamin B12 supplementation, her B12 levels rose from 2000 pg/mL to 7000 pg/mL over three months. Comprehensive testing, including liver and renal function tests, CBC, LDH, peripheral smear, thyroid function tests, homocysteine, methylmalonic acid levels, and imaging studies, revealed no abnormalities.

  Active holotranscobalamin was elevated, but there were no signs of malignancy or other serious conditions. The patient remained clinically stable throughout a six- month follow-up. This case highlights the importance of a structured approach in evaluating elevated serum cobalamin levels and considering macro-vitamin B12 in the differential diagnosis. Further research is needed to understand the clinical significance of macro-vitamin B12 and its impact on B12 level interpretation.

   

  Keywords: Macro-vitamin B12, Transcobalamins, Elevated serum cobalamin.