Clinical B12 deficiency in one case of recurrent spontaneous pregnancy loss.
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.
Candito
Mirande
M
INSERM U 145, Department of Biochemistry, Hôpital Pasteur, Nice, France. candito.m@chu-nice.fr
Magnaldo
Sarah
S
Bayle
Jacques
J
Dor
Jean-François
JF
Gillet
Yves
Y
Bongain
André
A
Van Obberghen
Emmanuel
E
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*
D005492:Folic Acid; D042965:Methylenetetrahydrofolate Reductase (NADPH2)