Fernández-Landázuri Sara, Baeza-Trinidad Ramón, Bernardo González Iván
Department of Biomedical Diagnostics, Hospital San Pedro, Logroño, Spain.
Service of Internal Medicine, Hospital San Pedro, Logroño, Spain.
Adv Lab Med. 2024 Aug 14;5(3):313-319. doi: 10.1515/almed-2024-0098. eCollection 2024 Sep.
Unexplained B12 hypervitaminosis (HB12) in asymptomatic patients leads to a cascade of medical consultations and diagnostic tests aimed at determining its etiology. The objective of this study was to assess the efficacy of the laboratory getting involved in the detection and elimination of immune complexes with vitamin B12 in clinical practice and its economic impact.
A retrospective longitudinal study was undertaken to assess the laboratory strategy of detecting B12 macrovitamin (macro-B12) in patients with HB12 >1,000 pg/mL. The clinical characteristics of patients with HB12 referred to Internal Medicine (IM) in the pre- and post-implantation period of the new strategy were compared. Additionally, the healthcare costs of one-year follow-up were estimated.
The prevalences of HB12 in the pre- and post-implantation period were 3.9 % and 3 %, respectively. Macro-B12 explained 25 % of the HB12 cases initially detected. A 41 % reduction was observed in the number of patients with HB12 after the implantation of the new strategy, thereby resulting in a cost reduction of 5,000 €.
The laboratory intervention for the detection of macro-B12 provides clear economic and clinical benefits in clinical practice.
无症状患者中不明原因的维生素B12过多症（HB12）会引发一系列旨在确定其病因的医学咨询和诊断测试。本研究的目的是评估实验室参与临床实践中检测和消除与维生素B12结合的免疫复合物的效果及其经济影响。
开展一项回顾性纵向研究，以评估对HB12>1000 pg/mL患者检测B12大维生素（巨维生素B12，macro-B12）的实验室策略。比较了新策略实施前后转诊至内科（IM）的HB12患者的临床特征。此外，还估算了一年随访的医疗费用。
实施新策略前后HB12的患病率分别为3.9%和3%。巨维生素B12解释了最初检测到的HB12病例中的25%。新策略实施后，HB12患者数量减少了41%，从而使成本降低了5000欧元。
实验室检测巨维生素B12的干预措施在临床实践中具有明显的经济和临床效益。
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