Rheumatology International

, Volume 24, Issue 1, pp 14–19 | Cite as

Anemia, serum vitamin B12, and folic acid in patients with rheumatoid arthritis, psoriatic arthritis, and systemic lupus erythematosus

  • Refael Segal
  • Yehuda Baumoehl
  • Ori Elkayam
  • David Levartovsky
  • Irena Litinsky
  • Daphna Paran
  • Irena Wigler
  • Beni Habot
  • Arthur Leibovitz
  • Ben Ami Sela
  • Dan Caspi
Original Article

Abstract

Objective

Although anemia is frequent in inflammatory rheumatic diseases, data regarding vitamin B12 status is scarce. The purpose of this study was to analyze the incidence and nature of B12 and folic acid (FA) deficiencies in a cohort of rheumatic patients with rheumatoid arthritis (RA), psoriatic arthritis (PsA), and systemic lupus erythematosus (SLE).

Methods

Levels of B12, FA, and parameters of anemia were recovered or examined in 276 outpatients. In those with recent findings of low serum B12 levels, further studies of serum homocysteine (Hcy) and urine methylmalonic acid (MMA) levels were performed.

Results

The incidence of anemia was high: 49%, 46%, and 35%, in RA, SLE, and PsA, respectively. Low levels of serum B12 were also frequent (24%), with almost similar occurrence in the three disease groups. Deficiency in FA was rare (<5%). Mean levels of both vitamins did not differ significantly among the three groups. No correlation between serum B12 levels and anemia was found. In the 15 patients with recently detected low B12 levels, Hcy and MMA were evaluated before and following B12 therapy. In ten of them, baseline Hcy levels were high, while MMA was increased in one patient only. Response to B12 administration, i.e., a decrease in Hcy and/or MMA levels, was noticed in four patients only, suggesting that only 26% of the low-serum-B12 patients had true B12 deficiency.

Conclusions

The incidences of anemia and decreased serum B12 levels were high in these three groups of rheumatic patients. However, true tissue deficiency seems to be much rarer.

Keywords

Folic acid Psoriatic arthritis Rheumatoid arthritis Systemic lupus erythematosus Vitamin B12 

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Copyright information

© Springer-Verlag 2004

Authors and Affiliations

  • Refael Segal
    • 1
    • 4
  • Yehuda Baumoehl
    • 1
    • 4
  • Ori Elkayam
    • 2
    • 4
  • David Levartovsky
    • 2
    • 4
  • Irena Litinsky
    • 2
    • 4
  • Daphna Paran
    • 2
    • 4
  • Irena Wigler
    • 2
    • 4
  • Beni Habot
    • 1
    • 4
  • Arthur Leibovitz
    • 1
    • 4
  • Ben Ami Sela
    • 3
    • 4
  • Dan Caspi
    • 2
    • 4
  1. 1.Department of GeriatricsShmuel-Harofeh Geriatric Medical CenterBaer YaakovIsrael
  2. 2.Rheumatology DepartmentSourasky Medical CenterTel AvivIsrael
  3. 3.Department of ChemistrySheba Medical CenterTel HashomerIsrael
  4. 4.Sackler Faculty of MedicineTel Aviv UniversityTel AvivIsrael

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