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Holotranskobalamin II’nin RIA ile Ölçümünün Megaloblastik Anemi Tanısındaki Değeri ve Diğer Tanı Parametreleri ile Karşılaştırılması

Value of Holotranscobalamin II Measured by RIA in the Diagnosis of Megaloblastic Anemia in Comparison with other Diagnostic Parameters

Journal Name:

  • Uludağ Üniversitesi Tıp Fakültesi Dergisi

Publication Year:

  • 2006

Key Words:

Keywords (Original Language):

Author NameUniversity of Author
Abstract (2. Language): 
The presence of variations in the clinical signs and laboratory findings of megaloblastic anemia due to cobalamin deficiency causes difficulty in the diagnosis. While decreased serum levels of holo-transcobalamin II (holoTC II) is thought to be an early marker in the diagnosis of cobalamin deficiency, no suitable method for clinical use has been developed. In this study, determination of the value of a new commercial test, holoTC II RIA in the diagnosis of cobalamin deficiency, and the comparison of this test with other laboratory markers were aimed. At the admission, anemia and macrocytosis, thrombocytopenia, neutropenia, cobalamin levels <100 pg/mL, and holo tc II levels less than normal (<37 pmol/L) were found in 14 (70%), 9 (45%), 7 (35%), 10 (50%), and 19 (95%) of the 20 patients, respectively. After a 10-day course of 1 mg/day cobalamin treatment, a significant increase occurred in the value of hemoglobin, hematocrite, thrombocyte, and serum cobalamin and holoTC II when compared to their respective values before the therapy (P<0.05). But, a decrease in the values of MCV, LDH, and unconjugated bilirubin occurred (P<0.05). It was found that the measuring of the plasma levels of holo TC II has a higher sensitivity and specificity in the determination of cobalamin deficiency.
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Abstract (Original Language): 
Kobalamin eksikliğine bağlı megaloblastik aneminin değişken klinik belirti ve laboratuvar bulgularının olması tanıda zorluklara neden olmaktadır. Serum holotranskobalamin II (holoTC II) düzeyinin azalmasının kobalamin eksikliğinin tanısında erken bir markır olduğu belirtilmekle birlikte, klinik kullanıma uygun bir metot geliştirilmemiştir. Bu çalışmada, kobalamin eksikliğini belirlemede yeni bir ticari test olan holoTC II RIA (Radyoimmüno assay)’nın etkinliği ve diğer laboratuvar bulguları ile karşılaştırılması amaçlandı. Başvuru anında, 20 hastanın 14‘ünde (%70) anemi ve makrositoz, dokuzunda (%45) trombositopeni, yedisinde (%35) nötropeni, 10’unda (%50) serum kobalamin düzeyleri (<100 pg/mL) ve 19’unda (%95) holoTC II düzeyi düşük (<37 pmol/L) bulundu. On gün 1 mg/gün siyanokobalamin tedavisi sonrası hemoglobin, hematokrit, trombosit, serum kobalamin ve serum holoTC II değerlerinde tedavi öncesi ile mukayese edildi- ğinde istatistiksel olarak anlamlı derecede artış oldu (P<0.05). MCV, LDH ve indirekt bilirübin değerlerinde ise azalma oldu (P<0.05). Plazma holoTC II düzeyinin ölçümünün kobalamin eksikliğini belirlemede daha yüksek özgüllük ve duyarlılığa sahip olduğu bulundu.
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  • Turkish

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