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Scand J Clin Lab Invest. 2018 Jul;78(4):333-334. doi: 10.1080/00365513.2018.1447143. Epub 2018 Mar 7.

Transient plasma cobalamin elevation in patients with pneumonia - two case reports.

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a Department of Geriatric Medicine , Odense University Hospital , Odense C , Denmark.
b Department of Clinical Biochemistry , Odense University Hospital , Odense C , Denmark.
c Institute of Clinical Research , University of Southern Denmark , Odense C , Denmark.


We report two cases of transient significantly elevated plasma cobalamin (B12) in geriatric patients acutely admitted with fever, increased C-reactive protein and X-ray verified pneumonia. Extensive diagnostic workup did not reveal kidney or liver disease, neither any signs of cancer. Furthermore, none of the patients had received therapeutic B12 supplementation prior to admission. In both cases, plasma B12 normalized at an out-patient control few months later. We were not able to identify the reason for the initial B12 elevation in any of the patients, since none of the usually recognized causes were evident. Since both patients had an infection and temporarily elevated B12, we suggest a possible inflammatory response or a vitamin B12 production by the infectious agents as the cause. Both suggestions, however, need further exploration.


B12; CRP and biochemical markers of infection; cobalamin; geriatrics; infection; inflammation

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