Hematological Parameters versus Serum Vitamin B12 Levels in the Diagnosis of Vitamin B12 Deficiency Neurological Deficits

Vitamin B12 is an important substrate for various enzymes that act as a co factor ( adenosylcobalamin) in the conversion of methyl malonyl coA to succinyl coA. Deficiency of vitamin b12 causes the accumulation of methylmalonyl co A as well as impaired dna synthesis leading to impaired myelin production and impaired olingodendrocyte growth and can affect any part of neuroaxis with involvement of other systems as well. Vitamin b12 deficiency causes megaloblastic ( dimorphic) anemia that manifests as raised mcv and reduced hemoglobin. Present study concentrates on correlation between this hematological parameters like mcv, hemoglobin, b12 levels and clinical symptomology of myelopathy, neuropathy or myeloneuropathy. The study determines that estimation mcv and hemoglobin are not sufficient enough to correlate the symptoms as patient may still have low serum b12 levels despite normal mcv and hemoglobin the determination of which is important as its a potentially treatable disorder if treated at earliest. It determines that there is poor correlation between the clinical symptoms and estimation of hemoglobin and mcv and requires estimation of serum b12 levels for definitive diagnosis.