Diagnostic Associations of Hypercobalaminemia in Indian Population

• Main Authors: Swarnima Singh, Rekha Kumar
• Format: Article
• Language: English
• Published: JCDR Research and Publications Pvt. Ltd. 2020-10-01
• Series: National Journal of Laboratory Medicine
• Subjects: cancer; cobalamin; haptocorrin; vitamin b12
• Online Access: http://www.njlm.net/articles/PDF/2415/45420_edited%20Final%20file_F(SHU)_PF1(AG_SHU)_PFA(SHU)_PB(AG_SHU)_PN(SHU)_PF2(MG_OM).pdf

Introduction: Serum cobalamin (Cbl) measurements are routinely done to rule out its deficiency. Surprisingly, a high fraction of these patients display hypercobalaminemia. Aim: To study hypercobalaminemia in hospital referred patients and their aetiological profile. Materials and Methods: Samples received for Cbl measurement were divided into four groups as per their Cbl levels- low <200pmol/L, normal 200-600 pmol/L, high 601-1000 pmol/L and very high>1000 pmol/L. Surplus serum was further analysed for holotranscobalamin (holo TC) and Haptocorrin (HC). Results: High Cbl was significantly associated with chronic alcoholism, liver disease and cancers. Patients with Cbl>1000 pmol/L showed higher risk of all cancer subtypes (myeloid, lymphatic, solid tumours); with highest risk for myeloid cancers. Distinctly higher median holo TC and HC levels were observed in groups with very high/high Cbl levels. Cancer, alcoholism, liver disease, renal, autoimmune and bronchopulmonary diseases showed HC above the reference range, the highest being that of cancer group. Conclusion: High Cbl levels are as frequent as low cobalamin levels in clinical practice, and merits a full diagnostic work up. Cancer (especially myeloid), chronic alcoholism, liver disease have showed consistent association with high Cbl and HC levels.