De betekenis van een te hoge cobalamineconcentratie in het bloed

- Elevated levels of serum cobalamin may be a sign of a serious, even life-threatening, disease.

- Diseases such as chronic myeloid leukaemia, promyelocytic leukaemia, polycythaemia vera and hypereosinophilic syndrome are often accompanied by markedly elevated levels of cobalamin in the blood. A rise in the serum cobalamin concentration is one of the diagnostic criteria for polycythaemia vera and hypereosinophilic syndrome.

- In haematological disorders, the increase in circulating cobalamin levels is predominantly caused by enhanced production of haptocorrin.

- Several liver diseases such as acute hepatitis, cirrhosis of the liver, hepatocellular carcinoma and metastatic liver disease can also be accompanied by an increase in circulating cobalamin.

- In liver diseases, the increase in cobalamin is predominantly caused by cobalamin release during hepatic cytolysis and/or through decreased clearance of circulating cobalamin by the affected liver.

- Liver disorders are not an indication for determining the serum cobalamin concentration.

- However, a coincidentally observed elevated serum cobalamin concentration is reason for further investigation.