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Available online 24 January 2023
Vitamin B12: For more than just the treatment of megaloblastic anemia?
Vitamina B12: ¿para algo más que el tratamiento de la anemia megaloblástica?
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A.J. Pardo-Cabelloa,
Corresponding author
, V. Manzano-Gamerob, E. Puche-Cañasc
a Servicio de Medicina Interna, Hospital Universitario San Cecilio, Granada, Spain
b Servicio de Medicina Interna, Hospital Universitario Virgen de las Nieves, Granada, Spain
c Departamento de Farmacología, Facultad de Medicina, Universidad de Granada, Granada, Spain
Received 04 November 2022. Accepted 23 November 2022
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Abstract

Vitamin B12, or cobalamin, belongs to the group of water-soluble vitamins and is ingested through food of animal origin such as eggs, milk, red meat and poultry, fish, and shellfish. Its clinical indication is the treatment of hypovitaminosis B12 administered orally or intramuscularly in the form of hydroxocobalamin. Hypovitaminosis B12 is mainly caused by deficient dietary intake (individuals with malnutrition, vegetarians or vegans, older adults, pregnant people, individuals with alcohol use disorder); when intestinal absorption is reduced (atrophic gastritis, malabsorption syndrome, gastrointestinal surgery); and for causes associated with the intake of drugs (antacids, metformin). Hypervitaminosis B12 has been associated with renal failure; liver diseases such as cirrhosis and acute-phase hepatitis; alcohol use disorder with or without liver involvement; solid tumors of the lung, liver, esophagus, pancreas, and colorectum; and in hematological malignancies such as leukemia and bone marrow dysplasia.

Keywords:
Cyanocobalamin
Vitamin B12 deficiency
Hypervitaminosis B12
Vitamin B12
Resumen

La vitamina B12 o cobalamina pertenece al grupo de vitaminas hidrosolubles y su aporte se realiza a través de la ingesta de alimentos de origen animal como huevo; leche; carnes rojas y de aves; pescados y mariscos. Su indicación clínica es el tratamiento de la hipovitaminosis B12 administrada por vía oral o intramuscular en forma de hidroxicobalamina. La hipovitaminosis B12 se origina, principalmente, por un déficit de aporte en la dieta (malnutrición, sujetos vegetarianos o veganos, ancianos, embarazo, alcoholismo); cuando está disminuida su absorción intestinal (gastritis atrófica, síndrome de malabsorción intestinal, cirugía gastro-intestinal) y asociada a ingesta de fármacos (antiácidos, metformina). La hipervitaminosis B12 se ha relacionado con la insuficiencia renal; hepatopatías como cirrosis y hepatitis en fase aguda; alcoholismo con o sin afectación hepática; tumores sólidos de pulmón, hígado, esófago, páncreas y colorrectal y en neoplasias hematológicas como leucemia y la displasia medular.

Palabras clave:
Cianocobalamina
Deficiencia de vitamina B12
Hipervitaminosis B12
Vitamina B12

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