The effect of liver disease on serum vitamin B12 concentrations.

Abstract

Abstract 1.1. Serum vitamin B 12 concentrations were determined in 36 patients with liver disease; 11 patients had alcoholic cirrhosis, 10 patients had postnecrotic cirrhosis, 6 patients had acute viral hepatitis, 5 patients had biliary cirrhosis, and 4 patients were studied during liver coma. 2.2. All of the patients had total serum vitamin B 12 levels markedly elevated over the normal control values with the exception of those with biliary cirrhosis. 3.3. Patients with acute inflammation and necrosis had relatively high levels of free vitamin B 12 while those with chronic liver disease had elevated bound vitamin B 12 . 4.4. Twenty-four-hour urine collections were assayed for vitamin B 12 content in 14 patients with liver disease and in 10 normal controls. All of the patients with liver disease excreted comparatively large amounts of vitamin B 12 . 5.5. In vitro incubation studies and in vivo tolerance tests were done in both normal subjects and patients with liver disease in an effort to study the binding capacity of the serum. In most of the cases the serum binding capacity appeared to be saturated when studied by either of these techniques. 6.6. The possible significance of these results is discussed.