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Made Gian Indra Rahayuda
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Health Professions Medicine & Pharmacology

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METHYLMALONIC ACID AND HOMOCYSTEIN SERUM IN DIAGNOSING MEGALOBLASTIC ANEMIA DUE TO COBALAMIN AND FOLATE DEFICIENCY IN TRAVEL MEDICINE Made Gian Indra Rahayuda; Sianny Herawati
E-Jurnal Medika Udayana vol 3 no 1 (2014):e-jurnal medika udayana
Publisher : Universitas Udayana

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Abstract

Anemia is a major global health problem, especially in developing countries. Anemia is a condition where the red blood cell mass and / or hemoglobin mass that circulating in the body was decreased to below normal level so it can not function well in providing oxygen to the body tissues. One of the most common type is megaloblastic anemia. Megaloblastic anemia is mostly caused by vitamin B12 (cobalamin) and folate deficiency. One of the causes of cobalamin and folate deficiency anemia is tropical sprue. Cobalamin deficiency anemia and folate deficiency anemia gives a similar symptom, but in cobalamin deficiency there is neuropathy symptoms. Normal serum folate is between 3-15 ng/mL. Normal folate erythrocyte is 150-600 ng/mL. In cobalamin deficiency, serum cobalamin decreased below the cut off point 100pg/mL (normally 100 - 400pg/mL). Other examination such as elevated homocysteine??, methylmalonic acid, or formioglutamic acid (FIGLU) in the urine can confirm the diagnosis of cobalamin and folic acid deficiency. There is no consensus on the cut-off point of homocysteine ??and MMA. Homocysteine ??has been considered to increase when the levels are above 12-14 ?mol /L in women and in the 14-15 ?mol/L. According to research by Robert et al in the case of cobalamin deficiency, serum tHcy> 15.0 ?mol/L. Most research considers the increase of MMA in cobalamin deficiency is> 0:28 ?mol / L, but the cut off point in circulation varies between 0:21 to 0:48 ?mol/L. MMA level is increased in serum and urine in cobalamin deficiency, whereas MMA normal in folate deficiency.
SERUM METHYLMALONIC ACID DAN HOMOCYSTEIN DALAM MENDIAGNOSIS ANEMIA MEGALOBLASTIK AKIBAT DEFISIENSI KOBALAMIN DAN FOLAT PADA TRAVEL MEDICINE Made Gian Indra Rahayuda; Sianny Herawati
E-Jurnal Medika Udayana vol 3 no 7 (2014):e-jurnal medika udayana
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (315.474 KB)

Abstract

Anemia adalah salah satu masalah kesehatan global yang utama, terutama pada negara-negara berkembang.Anemia adalah kondisi dimana massa sel darah merah dan/atau massa hemoglobin yang beredar dalam tubuh menurun hingga dibawah kadar normal sehingga tidak dapat berfungsi dengan baik dalam menyediakan oksigen untuk jaringan tubuh. Salah satu jenis yang banyak ditemukan adalah anemia megaloblastik.Anemia megaloblastik paling banyak disebabkan oleh kekurangan vitamin B12(kobalamin) dan folat.Salah satu penyebab anemia defisiensi kobalamin dan folat adalah tropical sprue.Anemia defisiensi kobalamin dan asam folat memberikan gambaran yang serupa namun pada defisiensi kobalamin terdapat gejala neuropati.Batas normal serum folat antara 3-15 ng/mL.Folat eritrosit batas normalnya dari 150 – 600 ng/mL.Pada defisiensi kobalamin, serum kobalamin menurun di bawah cut off point100pg/mL (normalnya 100- 400pg/mL).Pemeriksaan lain seperti homocystein, methylmalonic acid, atau formioglutamic acid(FIGLU) yang meningkat pada urin dapat memastikan diagnosis defisiensi kobalamindan asam folat. Belum ada konsensus mengenai cut off point Homocystein dan MMA. Homocysteine telah dianggap meningkat bila kadarnya di atas 12-14 µmol/L pada wanita dan di atas 14-15 µmol/L. Menurut penelitian yang dilakukan Robert et al pada kasus defisiensi kobalamin, kadar serum tHcy> 15.0 µmol/L.Kebanyakan penelitian menganggap peningkatan MMA pada defisiensi kobalamin adalah >0.28 µmol/L, tapi cut off point yang beredar bervariasi antara 0.21-0.48 µmol/L.Kadar MMA meningkat dalam serumdan urin pada defisiensi kobalamin, sedangkan pada defisiensi folat MMA normal.
Co-Authors Sianny Herawati