Cerebrospinal fluid methylmalonic acid concentrations in neurological patients with low and normal serum cobalamin concentrations.
OBJECTIVE
To determine whether cerebrospinal fluid (CSF) methylmalonic acid (MMA) is increased in neurological patients with low serum cobalamin (Cbl, vitamin B12) concentrations as opposed to neurological patients with normal serum Cbl concentrations.


METHODS
We measured MMA concentrations in serum and CSF of neurological patients with low serum cobalamin concentrations, but without overt cobalamin related manifestations such as anemia or combined disease of the cord, and neurological patients with normal serum cobalamin concentrations (controls).


RESULTS
Serum and CSF MMA concentrations were significantly higher in patients than in controls. Serum MMA was elevated in 4 patients of whom 3 had clearly elevated CSF MMA concentrations.


CONCLUSIONS
Strong indications for cobalamin deficiency can be found not only in serum but also in CSF of patients with seemingly asymptomatic low serum cobalamin concentrations.
Department of Geriatric Medicine, University Hospital Nijmegen, The Netherlands.
D Z
DZ
van Asselt
M H
MH
Karlietis
P J
PJ
Poels
J G
JG
de Jong
R A
RA
Wevers
W H
WH
Hoefnagels
D000328:Adult; D000368:Aged; D001927:Brain Diseases / Q000097:blood / Q000134:cerebrospinal fluid / Q000150:complications; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000097:blood / Q000134:cerebrospinal fluid / Q000150:complications; D008764:Methylmalonic Acid / Q000134:cerebrospinal fluid*; D008875:Middle Aged; D014805:Vitamin B 12 / Q000097:blood*
D008764:Methylmalonic Acid; D014805:Vitamin B 12