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Author Spotlight: Studying the Impact of Maternal Dietary Deficiencies on Long-Term Offspring Health Outcomes
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Elevated serum cobalamin levels in childhood: a retrospective analysis

Furkan Kalayci1, Metin Yigit2, Gozde Melisa Kalyoncu Arican3

  • 1Department of Pediatrics, Ankara Bilkent City Hospital, Bilkent, Ankara, 06800, Turkey. drfurkankalayci@gmail.com.

BMC Pediatrics
|October 30, 2025
PubMed

Insights

Elevated serum cobalamin (Cbl) in children can signal serious conditions like cancer, even if asymptomatic. Persistent high Cbl levels warrant investigation and careful monitoring to rule out underlying diseases.

Area of Science:

  • Pediatric Endocrinology
  • Clinical Biochemistry
  • Oncology

Background:

  • Cobalamin (Cbl), a vital water-soluble vitamin, has well-documented deficiency implications.
  • The clinical significance of elevated serum Cbl levels, especially in pediatric populations, remains poorly understood.
  • This study addresses the diagnostic uncertainty surrounding high Cbl levels in children.

Purpose of the Study:

  • To investigate clinical and laboratory findings in pediatric patients with excessively high serum Cbl levels.
  • To identify potential underlying causes and clinical outcomes associated with elevated Cbl.
  • To clarify the diagnostic value of high Cbl levels in pediatric cases.

Main Methods:

  • Retrospective analysis of pediatric patients with serum Cbl > 1500 ng/mL.
  • Data collected included demographics, Cbl treatment history, chronic disease status, laboratory results, and imaging findings.
  • Evaluation conducted at Ankara Bilkent City Hospital from January to May 2024.

Main Results:

  • 388 pediatric patients were analyzed; 45.4% had a history of Cbl treatment, showing significantly higher Cbl levels.
  • Leukemia and tumors were the most common chronic diseases associated with high Cbl.
  • While 81.3% were asymptomatic, five patients without prior diagnosis developed malignancies (rhabdomyosarcoma, AML, lymphomas, CML).
  • Ultrasonographic abnormalities (steatosis, hepatosplenomegaly) were more frequent in patients with high Cbl.
  • Chronic disease patients had higher Cbl levels and longer normalization periods.

Conclusions:

  • Persistently elevated serum Cbl in children, even if asymptomatic, may indicate serious underlying conditions, including malignancies.
  • Close monitoring and further investigation are crucial for pediatric patients with unexplained high Cbl levels.
  • Avoidance of unnecessary Cbl supplementation is recommended to prevent misleading results and ensure accurate diagnosis.
Abstract

Keywords:
ChildrenCobalaminHypercobalaminemiaPediatricVitamin B12

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