Could Mean Platelet Volume and Red Cell Distribution Width Predict Vitamin B12 Deficiency.

Aims: Vitamin B12 deficiency causes an increase in homocysteine levels which is associated with inflammatory conditions. Mean platelet volume (MPV) and red cell distribution width (RDW) are also associated with inflammation. Therefore, we aimed to compare hematological parameters in patients with and without vitamin B12 deficiency to find out whether they could predict vitamin B12 deficiency. Methods: Patients who underwent vitamin B12 assessment grouped based on the serum level of vitamin B12. We grouped 116 patients, whose B12 level was lower than 250, in first group and 62 patients, whose B12 ≥ 250 pg/ml, in second group. Results: Red cell distribution width was significantly higher in group 1 (patients with a vitamin B12 level lower than 250 pg/ml) compared to those in group 2 (patients with a vitamin B12 level higher than 250 pg/ml). Mean platelet volume was significantly lower in group 1 compared to group 2. Conclusion: We suggest that MPV and RDW should be an indicator of vitamin B12.deficiency especially in early stages of the disease. However, prospective studies with larger cohort are needed to confirm our results.

Phantom Human Chorionic Gonadotropin in an End Stage Renal Disease Case.

Aims: Gestation is very difficult in women with end stage renal disease (ESRD). In addition, human chorionic gonadotropin (HCG) may be increased in Non-pregnant women with ESRD. Therefore, elevated HCG levels in ESRD patients may cause diagnostic confusion. Here we present a case with suspicious HCG elevation who desire of pregnancy and without gonadal deficiency. We also discussed the possible reasons of this HCG elevation. Presentation of Case: A twenty-two year old young woman with ESRD for seven years has been followed up outpatient clinics of our institution. She was receiving hemodialysis treatment for last three years after renal transplant rejection. In gynecological examination, obstetric ultrasound scan revealed no embryonic yolk sac or other radiological images of pregnancy. The case evaluated according to the algorithm of HCG elevation. Advanced clinical differential diagnosis and laboratory analyzes were performed. A diagnosis of HCG elevation due to heterophile antibodies made, which has not been previously described in the literature in ESRD patients. Discussion and Conclusion: Heterophile antibodies should be kept in mind in evaluation of HCG increase in reproductive women with ESRD patients with transplantation history.