无法解释的维生素B12升高:考虑宏观B12
Evelien G E Hurkmans1, Ruben Deneer1,2, Marten R Nijziel3
1Clinical Laboratory, Catharina Hospital Eindhoven, Eindhoven, the Netherlands.
International journal of laboratory hematology
|January 7, 2026
概括
麦克罗-B12是一种导致维生素B12水平高的复合物,在24%的患者中发现. 这种测试可以帮助避免不必要的程序,如骨髓活检,当骨髓恶性瘤不太可能.
科学领域:
- 临床化学 临床化学
- 血液学 血液学 血液学
- 免疫学 免疫学 免疫学
背景情况:
- 维生素B12的升高可能源于各种原因,包括补充剂,肝脏/脏疾病或骨髓性恶性瘤.
- 持续高维生素B12水平可能会导致患者焦虑,并导致侵入性诊断.
- 麦克罗-B12是维生素B12和免疫球蛋白的复合物,是维生素B12升高的良性原因,原因是清除率降低.
研究的目的:
- 调查聚乙烯糖醇 (PEG) 沉在识别宏观B12中的实用性.
- 评估宏B12是否可以防止不必要的侵入性诊断程序.
- 为了研究患有和没有骨髓瘤恶性瘤的患者中宏B12的患病率.
主要方法:
- 聚乙烯糖醇 (PEG) 沉试验被用于检测宏B12.
- 一个案例研究说明了PEG沉的潜力,以避免骨髓活检.
- 在患者中评估了维生素B12含量升高的患者,有或没有骨髓性恶性瘤.
主要成果:
- 在72名具有维生素B12>1476 pmol/L的个体中,24%的个体中发现了宏观B12.
- 一名患有宏B12的患者表现出功能性维生素B12缺乏 (甲基马龙酸升高).
- 在8名患有骨髓性恶性瘤的患者中没有检测到宏B12.
结论:
- PEG沉可以帮助识别宏B12作为维生素B12升高的原因.
- 这种测试可以防止在特定患者中进行不必要的诊断程序,例如骨髓穿孔.
- 在本研究队列中,宏B12与髓状质恶性瘤无关.
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