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Serum Homocysteine Levels in Multiple Sclerosis

J. Río, MD; J. Montalban, MD; M. Tintoré, MD; A. Codina, MD; M. R. Malinow, MD
Arch Neurol. 1994;51(12):1181-1181. doi:10.1001/archneur.1994.00540240025007
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Recent articles1,2 on the association of vitamin B12 deficiency and multiple sclerosis (MS) have revived interest in vitamin B12 metabolism in MS. In both disorders, demyelination is a noteworthy feature; however, MS is clearly different from vitamin B12 deficiency. Vitamin B12 deficiency is usually a disorder of the middle or late stage of life and rarely occurs in the age range typical for the presence of MS.3 Mild but significant macrocytosis has been found in patients with MS compared with an age- and sex-matched neurological control group.4 Significant lowering of the serum vitamin B12 concentration has also been reported in patients with MS.5 This association, however, remains unclear because convincing evidence of clinical abnormalities attributable to vitamin B12 deficiency in patients with MS was not documented by the authors. Although the serum vitamin B12 assay is an extremely sensitive

REFERENCES

Reynolds EH, Linnell JC.  Vitamin B12 deficiency, demyelination and multiple sclerosis . Lancet . 1987;;2:920.
Reynolds EH, Linnell JC, Faludy JE.  Multiple sclerosis associated with vitamin B12 deficiency . Arch Neurol . 1991;;48:808-811.
Chanarin I. The Megaloblastic Anaemias . Oxford, England: Blackwell Scientific Publications; 1979;.
Crellin RF, Bottiglieri T, Reynolds EH.  Multiple sclerosis and macrocytosis . Acta Neurol Scand . 1990;;81:388-391.
Reynolds EH, Bottiglieri T, Laundy M, Crellin RF, Kirker SG.  Vitamin B12 metabolism in multiple sclerosis . Arch Neurol . 1992;;49:649-653.
Allen RH, Stabler SP, Savage DG, Lindenbaum J.  Diagnosis of cobalamin deficiency, I: usefulness of serum methylmalonic acid and total homocysteine concentrations . Am J Hematol . 1990;;34:90-98.
Poser CM, Paty DW, Scheinberg L, et al.  New diagnostic criteria for multiple sclerosis: guidelines for research protocols . Ann Neurol . 1983;;13:227-231.
Malinow MR, Kang SS, Taylor MM, et al.  Prevalence of hyperhomocyst(e)inemia in patients with peripheral arterial occlusive disease . Circulation . 1989;; 79:1180-1188.
Malinow MR, Sexton G, Averbuch M, Grossman M, Wilson D, Upson B.  Homocyst(e)inemia in daily practice: levels in coronary artery disease . Coron Artery Dis . 1990;;1:215-220.
Reynolds EH.  Multiple sclerosis and vitamin B12 metabolism .J Neurol Neurosurg Psychiatry . 1992;;55:339-340.
Compston DAS.  Genetic susceptibility to multiple sclerosis . In: Matthews WB, ed. McAlpine's Multiple Sclerosis . New York, NY: Churchill Livingstone Inc; 1991;:301-319.

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Reynolds EH, Linnell JC.  Vitamin B12 deficiency, demyelination and multiple sclerosis . Lancet . 1987;;2:920.
Reynolds EH, Linnell JC, Faludy JE.  Multiple sclerosis associated with vitamin B12 deficiency . Arch Neurol . 1991;;48:808-811.
Chanarin I. The Megaloblastic Anaemias . Oxford, England: Blackwell Scientific Publications; 1979;.
Crellin RF, Bottiglieri T, Reynolds EH.  Multiple sclerosis and macrocytosis . Acta Neurol Scand . 1990;;81:388-391.
Reynolds EH, Bottiglieri T, Laundy M, Crellin RF, Kirker SG.  Vitamin B12 metabolism in multiple sclerosis . Arch Neurol . 1992;;49:649-653.
Allen RH, Stabler SP, Savage DG, Lindenbaum J.  Diagnosis of cobalamin deficiency, I: usefulness of serum methylmalonic acid and total homocysteine concentrations . Am J Hematol . 1990;;34:90-98.
Poser CM, Paty DW, Scheinberg L, et al.  New diagnostic criteria for multiple sclerosis: guidelines for research protocols . Ann Neurol . 1983;;13:227-231.
Malinow MR, Kang SS, Taylor MM, et al.  Prevalence of hyperhomocyst(e)inemia in patients with peripheral arterial occlusive disease . Circulation . 1989;; 79:1180-1188.
Malinow MR, Sexton G, Averbuch M, Grossman M, Wilson D, Upson B.  Homocyst(e)inemia in daily practice: levels in coronary artery disease . Coron Artery Dis . 1990;;1:215-220.
Reynolds EH.  Multiple sclerosis and vitamin B12 metabolism .J Neurol Neurosurg Psychiatry . 1992;;55:339-340.
Compston DAS.  Genetic susceptibility to multiple sclerosis . In: Matthews WB, ed. McAlpine's Multiple Sclerosis . New York, NY: Churchill Livingstone Inc; 1991;:301-319.

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