To evaluate the clinical characteristics, referral patterns, and underlying diagnoses of children referred to a pediatric hematology and oncology clinic due to elevated serum vitamin B12 levels.
Approach:
Study Design: Retrospective review of medical records of pediatric patients referred to a clinic between January 2022 and December 2024 for elevated serum vitamin B12 levels (>1000 pg/mL), excluding those with vitamin B12 supplementation or known chronic liver or renal dise…
Data Collection: Demographic data, indications for vitamin B12 testing, laboratory findings, and final diagnoses were recorded.
Key Findings:
A total of 50 children were included in the analysis, with elevated vitamin B12 levels most commonly detected incidentally during routine evaluations.
Most patients did not present with symptoms suggestive of underlying haematological malignancy.
Two patients were diagnosed with chronic myeloid leukaemia, both having additional clinical and laboratory abnormalities.
The remaining patients were found to have benign or inflammatory conditions or no identifiable underlying pathology.
Interpretation:
Isolated hypercobalaminaemia is a frequent cause of referral to pediatric hematology clinics but is rarely associated with malignancy. Most children referred for elevated vitamin B12 levels have benign or inflammatory conditions.
Limitations:
The study is limited to a specific time frame and location, which may affect generalizability.
The retrospective nature may introduce biases in data collection and interpretation.
Conclusion:
Elevated vitamin B12 levels should be interpreted within the clinical context, and awareness of referral patterns may assist in managing pediatric patients with hypercobalaminaemia.
