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Subtle Cobalamin Deficiency

Ralph Carmel, MD
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University of Southern California School of Medicine Los Angeles, CA 90033 Grant Support: Grant DK 32640 from the National Institutes of Health. Requests for Reprints: Ralph Carmel, MD, University of Southern California School of Medicine, 2025 Zonal Avenue, Raulston 306, Los Angeles, CA 90033.

Copyright ©2004 by the American College of Physicians

Ann Intern Med. 1996;124(3):338-340. doi:10.7326/0003-4819-124-3-199602010-00010
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As physicians, we tend to think of deficiency states in terms of their classic, generally florid features. In the case of cobalamin (vitamin B12) deficiency, these features include, first and foremost, megaloblastic anemia and neurologic dysfunction. Of course, all dividing cells are affected, but the sequelae outside the bone marrow and the nervous system are usually not clinically apparent.

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