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Orphanet J Rare Dis

Studies reviewed by Hector and Burton involving 91 patients with hypovitaminosis B12 who exhibited neuropsychiatric symptoms found that clinical improvement was achieved in many individuals through vitamin B12 replacement therapy (74)

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For patients without absorption disorders, high-dose oral supplements of 1,000 to 2,000 mcg daily have been shown to be comparably effective at correcting mild to moderate deficiency at lower cost and greater convenience.

Laboratory test results are shown below: Component Result AST, U/L ALT, U/L ALP, U/L Total bilirubin, mg/dL Serum albumin, g/dL CBC Hepatitis B surface antigen Hepatitis B surface antibody Hepatitis B core antibody, total Hepatitis C antibody ANA ASMA AMA Iron studies 1-Antitrypsin phenotype 70 84 90 0.9 4.0 Normal Negative Positive Negative Negative 1:40 Negative Negative Normal MM Ultrasonography of the liver shows an enlarged, echogenic liver with patent portal and hepatic veins and no radiographic signs of portal hypertension or cirrhosis