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Do high vitamin B12 levels in children matter?
  1. Mais Ismail1,
  2. Maria De Ferrars2,
  3. Rebecca Hilary Proudfoot1
  1. 1Paediatrics, York and Scarborough Teaching Hospitals NHS Foundation Trust, York, UK
  2. 2Biochemistry, York and Scarborough Teaching Hospitals NHS Foundation Trust, York, UK
  1. Correspondence to Dr Rebecca Hilary Proudfoot; rebecca.proudfoot1{at}nhs.net

https://doi.org/10.1136/archdischild-2024-328206

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    Vitamin B12 levels are often recommended for children. Locally, we note many children have B12 levels above the upper limit of normal (771 ng/L1). We receive frequent advice requests from GPs regarding high B12 and have found a paucity of evidence to guide our response.

    A Turkish retrospective study of 40 children with B12>1000 pg/mL concluded that high levels are usually benign, but some may develop leukaemia later.2 This was based on a leukaemia diagnosis in 2 out of 40 children within 3 years. They stated that in children with high B12 ‘all known disease should be excluded first by haematological, biochemical and radiological investigation’.

    These children were recruited from a specialist haematology service and had mostly been referred from other paediatric clinics. The pre-test probability of haematological malignancy was likely to be higher than in our local population and might not be related to …

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    Footnotes

    • Contributors RHP and MI analysed the data and wrote the text together. MDF provided the data and verified the text. RHP is the guarantor.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.