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• W4230281374 abstract "Déterminer les maladies associées à un taux plasmatique élevé de vitamine B12 et mesurer la force de l’association.Enquête rétrospective incluant les séjours hospitaliers du premier mai 2005 au 30 avril 2008 dans les services du pôle UMAG de notre hôpital (urgences, médecine interne, gériatrie aiguë et réanimation médicale) et ayant eu un dosage de vitamine B12. L’association entre chacun des codes Programme de médicalisation des systèmes d’information (PMSI) (cancers solides, hémopathies malignes et maladies rénales) et une valeur basse ou élevée de vitamine B12 (B12) a été mesurée par l’odds ratio (OR) à partir d’une régression logistique prenant en compte les hospitalisations multiples, avec ajustement sur l’âge et l’indice de comorbidité de Charlson pondéré.Parmi les 3702 séjours, 12 % avaient une B12 supérieure à 820 pg/mL, 10,4 % une B12 inférieure à 180 pg/mL et 77,6 % une B12 normale. Après ajustement sur l’âge et l’indice de Charlson pondéré, une B12 élevée était associée aux maladies interstitielles rénales (OR 2,7 ; (IC95 % : [1,7–4,2]) et aux cirrhoses ou hépatites (OR 4,3 ; [(2,9–6,4]). Après ajustement supplémentaire sur ces paramètres, la B12 restait indépendamment associée aux cancers (OR 1,8 ; [1,2–2,6]), aux hémopathies malignes (OR 2,1 ; |1,3–3,5]), aux métastases OR 2,9 (1,5–5,9), aux métastases hépatiques (OR 6,2 ; [2,7–14,5]), aux carcinomes hépatocellulaires (CHC) (OR 3,3 ; [1,1–10,4]), aux cancers du foie hors CHC (OR 4,7 ; [1,2–17,9]) et aux lymphomes (OR 3,2 ; [1,6–6,4]) mais pas au myélome (OR 1 ; [0,6–1,4]). Un taux bas de B12 était associée au myélome (OR 2,9 ; [1,3–6,6]).La découverte d’un taux élevé de vitamine B12 doit conduire à rechercher de manière systématique une maladie hépatique ou tumorale, et en premier lieu une localisation tumorale hépatique.To identify the diseases that are associated with a high plasma concentration of vitamin B12 and to measure the strength of this association.Retrospective study including all admissions between 1st May, 2005 and 30th April, 2008 in the UMAG pole departments (emergency, internal medicine, acute geriatrics and medical intensive care) with a test for plasma vitamin B12. The association between each of medical information system codes (solid tumors, malignant hematologic process, and renal disease) and a high or low vitamin B12 concentration was measured by odds ratios (OR) from logistic models taking into account repeated admissions, with adjustment for age and the weighted Charlson index.Among 3702 admissions, 12% had a B12 more than 820pg/ml, 10.4% a B12 less than 180 pg/ml and 77.6% a normal B12 concentration. After adjustment for age and the weighted Charlson index, high concentration of vitamin B12 was associated with interstitial renal diseases (OR 2.7; 95% CI: [1.7–4.2]), and cirrhosis or hepatitis (OR 4.3; [2.9–6.4]). After additional adjustment for these parameters, it was still associated with tumors (OR 1.8; [1.2–2.6]), malignant hematologic diseases (OR 2.1; [1.3–3.5]), metastasis (OR 2.9; [1.5–5.9]), liver metastasis (OR 6.2; [2.7–14.5]), liver carcinoma (LC) (OR 3.3; [1.1–10.4]), liver tumors other than LC (OR 4.7; [1.2–17.9]) and lymphoma (OR 3.2; [1.6–6.4]) but not with myeloma (OR 1.9; [0.6–1.4]). Low concentration of B12 was associated with myeloma (OR 2.9; [1.3–6.6]).Finding a high plasma concentration of vitamin B12 should lead to a systematic search for a hepatic disease or a tumor, and particularly for a hepatic localization of a tumor." @default.
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• W4230281374 date "2007-06-01" @default.
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• W4230281374 title "Implications cliniques de la découverte d'une hypervitaminémie B12 en médecine interne" @default.
• W4230281374 doi "https://doi.org/10.1016/j.revmed.2007.03.069" @default.
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