Cor Vasa 2004, 45(9):440-445

Hyperhomocysteinemias caused by vitamin B₁₂ deficiency and detected using selective screening in patients after Q-wave infarction, pulmonary embolism and deep vein thrombosis

Josef Hyánek^1,*, Jana Matoušková², Petr Kmoníček², Pavel Formánek², Petr Lepší², Karel Kopřiva², Ladislava Dubská¹, Jana Dvořáková¹, Hana Veselá¹, Karel Kupka⁴, Bohumil Malec⁴, Hedvika Pejznochová¹, Rudolf Hoffmann¹, Jozef Balasz¹, Věra Martiníková¹, Martina Vodičková¹, Josef Pola³

¹ Oddělení klinické biochemie - Metabolická a hematologická ambulance

² Koronární jednotka intenzivní péče, Kardiologické oddělení, Nemocnice Na Homolce, Praha

³ Interní oddělení, Nemocnice v Tanvaldě, Tanvald

⁴ Ústav nukleární medicíny, Všeobecná fakultní nemocnice a 1. lékařská fakulta Univerzity Karlovy, Praha, Česká republika

The authors report three cases of high blood homocysteine levels; a patient after a Q-wave myocardial infarction (142.5 µmol/L), another patient with massive pulmonary artery embolism (72 µmol/L) and a female patient with deep vein thrombosis (98 µmol/L) while having a normal lipid spectrum. All three patients, after the acute event had resolved, were found to have low levels of vitamin B>sub>12, with hyperhomocysteinemia identified as the only potential trigger. Subsequent examinations demonstrated evolving pernicious anemia successfully treated by cobalamine administration. Two patients were shown to be heterozygous for a MTHFR gene mutation.

Keywords: Vitamin B12 deficiency; Hyperhomocysteinemia; Q-wave infarction; Pulmonary embolism; Deep vein thrombosis

Published: September 1, 2004  Show citation