Laboratory markers during the second episode of anemia
| Markers . | Biological material . | Reference range . | Before treatment with folic acid* . | With folic acid treatment† . |
|---|---|---|---|---|
| Blood count | ||||
| Hemoglobin, g/L | 135-175 | 61-99 | 131 | |
| Red blood cells ×1012/L | 4-5.8 | 2.02-3.21 | 4.34 | |
| Hematocrit, % | 40-50 | 17.1-30.4 | 41 | |
| Mean cell volume, fL | 82-98 | 82.1-97.3 | 94.5 | |
| Reticulocytes, % | 0.5-2.5 | 0.62-3.71 | 0.52 | |
| Routine biochemistry | ||||
| Bilirubin, μmol/L | Serum | 2-17 | 42.2-60.6 | 17.4 |
| Lactate dehydrogenase, μkat/L | Serum | 1.67-3.17 | 13.38-115.66 | 2.6 |
| Ferritin, μg/L | Serum | 17-304 | 413.2-954.8 | 1036.3 |
| Iron, μmol/L | Serum | 7.2-29 | 49.4-50.5 | 6.7 |
| B vitamins and related metabolites | ||||
| Folate, nmol/L | Serum | 4.53-21.5 | 7.3-14.3 | >45 |
| Folate, nmol/L | Erythrocytes | 1185-2841 | 1155.2 | 2175.4 |
| Vitamin B12, ng/L | Serum | 197-771 | 138-2000 | 866 |
| Holotranscobalamin II, pmol/L | Serum | 19-119 | 44 | 151 |
| Total homocysteine, μmol/L | Plasma | 5.2-11.3 | 31.5 to ≥50 | 9.49 |
| Cystathionine, nmol/L | Plasma, serum | 80-1000 | 187-217 | 99 |
| Methionine, μmol/L | Plasma, serum | 12-40 | 26-27 | 17 |
| Sarcosine, μmol/L | Plasma, serum | 0.7-3 | 5.2 | 1.85 |
| Methylmalonic acid, nmol/L | Plasma | <270 | 136.8 | 204.5 |
| Methylmalonic acid, mmol/mol creatinine | Urine | <15 | <15 | <15 |
| AICAr, mmol/mol creatinine | Urine | 0.04-1.01 | 1.87 | 0.18 |
| Markers . | Biological material . | Reference range . | Before treatment with folic acid* . | With folic acid treatment† . |
|---|---|---|---|---|
| Blood count | ||||
| Hemoglobin, g/L | 135-175 | 61-99 | 131 | |
| Red blood cells ×1012/L | 4-5.8 | 2.02-3.21 | 4.34 | |
| Hematocrit, % | 40-50 | 17.1-30.4 | 41 | |
| Mean cell volume, fL | 82-98 | 82.1-97.3 | 94.5 | |
| Reticulocytes, % | 0.5-2.5 | 0.62-3.71 | 0.52 | |
| Routine biochemistry | ||||
| Bilirubin, μmol/L | Serum | 2-17 | 42.2-60.6 | 17.4 |
| Lactate dehydrogenase, μkat/L | Serum | 1.67-3.17 | 13.38-115.66 | 2.6 |
| Ferritin, μg/L | Serum | 17-304 | 413.2-954.8 | 1036.3 |
| Iron, μmol/L | Serum | 7.2-29 | 49.4-50.5 | 6.7 |
| B vitamins and related metabolites | ||||
| Folate, nmol/L | Serum | 4.53-21.5 | 7.3-14.3 | >45 |
| Folate, nmol/L | Erythrocytes | 1185-2841 | 1155.2 | 2175.4 |
| Vitamin B12, ng/L | Serum | 197-771 | 138-2000 | 866 |
| Holotranscobalamin II, pmol/L | Serum | 19-119 | 44 | 151 |
| Total homocysteine, μmol/L | Plasma | 5.2-11.3 | 31.5 to ≥50 | 9.49 |
| Cystathionine, nmol/L | Plasma, serum | 80-1000 | 187-217 | 99 |
| Methionine, μmol/L | Plasma, serum | 12-40 | 26-27 | 17 |
| Sarcosine, μmol/L | Plasma, serum | 0.7-3 | 5.2 | 1.85 |
| Methylmalonic acid, nmol/L | Plasma | <270 | 136.8 | 204.5 |
| Methylmalonic acid, mmol/mol creatinine | Urine | <15 | <15 | <15 |
| AICAr, mmol/mol creatinine | Urine | 0.04-1.01 | 1.87 | 0.18 |
Levels out of reference range are shown in bold; supraphysiological concentrations resulting from administration of respective vitamins are shown in italics.
Ranges with the minimal and maximal observed levels during the period in which therapy with cyanocobalamin only was administered (days 1155-1414; single values are from day 1261).
The levels at follow-up of 1 month of combined cyanocobalamin and folic acid therapy (day 1444, 3 days after the last cyanocobalamin injection).