title: Clinical B12 deficiency in one case of recurrent spontaneous pregnancy loss.
abstract: Moderate hyperhomocysteinaemia (HHcy) and the homozygous mutation C677T in the 5,10-methylenetetrahydrofolate reductase (MTHFR) gene are associated with increased risk of recurrent pregnancy loss. This HHcy is currently reported as a consequence of folate rather than of vitamin B12-deficient status. We describe one case of recurrent early pregnancy loss with HHcy caused by B12 deficiency. A 38-year old woman had four episodes of early spontaneous pregnancy loss. Biological data: no haemostasis disorders, HHcy (25.9 micromol/l), normal folate (5 ng/ml), B12 deficiency (< 150 pg/ml) and the MTHFR C677T homozygote genotype. A bone marrow biopsy gave evidence of moderate megaloblastosis. Parenteral B12 therapy led to normal homocysteine level within 2 months and to a successful pregnancy. In conclusion, vitamin B12 deficiency is one of the causes of recurrent pregnancy loss associated with HHcy, and serum B12 should be measured systematically in this circumstance.
authors.affiliation: INSERM U 145, Department of Biochemistry, Hôpital Pasteur, Nice, France. candito.m@chu-nice.fr
authors.forename: Mirande
authors.initials: M
authors.lastname: Candito
authors.forename: Sarah
authors.initials: S
authors.lastname: Magnaldo
authors.forename: Jacques
authors.initials: J
authors.lastname: Bayle
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Dor
authors.forename: Yves
authors.initials: Y
authors.lastname: Gillet
authors.forename: André
authors.initials: A
authors.lastname: Bongain
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Van Obberghen
mesh_terms: D000026:Abortion, Habitual / Q000097:blood / Q000209:etiology*; D000328:Adult; D005260:Female; D005492:Folic Acid / Q000097:blood; D006720:Homozygote; D006801:Humans; D020138:Hyperhomocysteinemia / Q000097:blood; D042965:Methylenetetrahydrofolate Reductase (NADPH2) / Q000235:genetics; D009154:Mutation / Q000235:genetics; D014806:Vitamin B 12 Deficiency / Q000097:blood / Q000150:complications*
chemical_list: D005492:Folic Acid; D042965:Methylenetetrahydrofolate Reductase (NADPH2)