B12 Vitamin Eksikliği Olan Hastalarda Kobalamin Tedavisi Öncesi ve Sonrası Ortalama Trombosit Volümünün Değerlendirilmesi

Amaç: B12 vitamin eksikliği toplumda sık görülen bir megaloblastik anemidir. B12 tedavisi kemik iliğindeki tüm serileri stimüle edebilir. Biz bu çalışmada B12 tedavisi sırasında periferik kana genç, aktif ve büyük trombositlerin salınıp salınmadığını ve bu trombositlerin varlığının iyi bir göstergesi olan ortalama trombosit hacmi (OTH) seviyesini araştırmayı amaçladık. Materyal ve Metod: Bu çalışmaya 40 erkek ve 160 kadın toplam 204 hasta dahil edildi. Kobalamin intramuskuler (İM) enjeksiyon yoluyla uygulandı. B12 tedavisinden önce ve tedaviden bir ay sonra hematolojik ve biyokimyasal testleri değerlendirdik. Bulgular: Hastaların yaş ortalaması 40.1 ± 17.4 yıl idi. Tedavi öncesi grupta, B12 vitamin seviyeleri 151.2 ± 34.6 pg/mL ve OTH 7.8 ± 1.4 fL idi. Tedavi sonrası grupta, B12 vitamin seviyeleri 638 ± 608 pg/mL ve OTH 8.3 ± 1.3 idi. Tedavi sonrası grupta B12 vitamin (P < 0.001) ve OTH (P < 0.001) tedavi öncesi gruptan anlamlı yüksekti. Sonuç: B12 eksikliği olan hastalarda İM kobalamin tedavisinin 1. ayı sonunda tedavi öncesi değerlere göre B12 ve OTH değerinin arttığı MCV değerinin düştüğü bulundu. Çalışmamızın sonuçları gösterdi ki İM B12 tedavisi sırasında büyük ve aktif trombositler perifere daha çok salınabilir; trombotik hastalıklara yatkın olan hastalarda dikkatli olmak gerekebilir.

Evaluation of Mean Platelet Volume Before and After Cobalamin Treatment in Patients with Vitamin B12 Deficiency

Purpose: Megaloblastic anemia due to vitamin B12 deficiency is common in the population. Vitamin B12 therapy may stimulate all cell types in the bone marrow. We investigated whether young, active and large platelets are released into the peripheral blood during vitamin B12 treatment and measured the level of mean platelet volume (MPV), an indicator of the presence of these platelets. Materials and Methods: A total of 204 patients (40 males, 160 females) with vitamin B12 deficiency were included in this study. Cobalamin was administered by intramuscular injections. We evaluated the hematologic and biochemical parameters before and after one month of vitamin B12 treatment. Results: The mean age of patients was 40.1 ± 17.4 years. In the pretreatment group, the mean level of vitamin B12 was 151.2 ± 34.6 pg/mL, the MPV was 7.8 ± 1.4 fL. In the posttreatment group, the mean vitamin B12 level was 638 ± 608 pg/mL, the MPV was 8.3 ± 1.3 fL. The levels of vitamin B12 (P < 0.001) and MPV (P < 0.001) were significantly higher in the posttreatment group than those in the pretreatment group. Conclusions: After one month of cobalamin treatment in patients with vitamin B12 deficiency, the levels of B12 and MPV were higher than the pretreatment levels. These results showed that vitamin B12 treatment may increases the release of large and active thrombocytes into the peripheral blood; therefore, caution may be needed in patients predisposed to thrombotic diseases.

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  • Yazışma Adresi / Address for Correspondence: Dr. Medine Cumhur Cure University of Recep Tayyip Erdogan, School of Medicine, Department of Biochemistry Islampasa mahallesi, 53100, R İZE e mail: medinecure@yahoo.com geliş tarihi/received :13.01.2014 kabul tarihi/accepted:31.01.2014
Cukurova Medical Journal-Cover
  • ISSN: 2602-3032
  • Yayın Aralığı: Yılda 4 Sayı
  • Başlangıç: 1976
  • Yayıncı: Çukurova Üniversitesi Tıp Fakültesi
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