Background
Vitamin B12 is one of the most complex vitamins. The measurement of serum levels and
the significance of the results are much debated in the literature.
Objective
This article discusses testing for vitamin B12 deficiency, its clinical manifestations and
the possible repercussions for Australia’s refugee population.
Discussion
Full blood count and blood film, iron studies and haemoglobinopathy studies are
routinely performed for newly arrived refugees in Australia. At the Migrant Health
Service in Adelaide, South Australia, a young woman was found to have a very unusual
blood picture with a normal mean cell volume, despite quite severe iron deficiency and
thalassaemia trait. Her vitamin B12 was found to be 75 pmol/L. The following week
there arose another case of an 11 month old breastfed baby with a vitamin B12 level
of 52 pmol/L, whose mother had a level of 300 pmol/L. Understanding the clinical
manifestations of vitamin B12 deficiency and how it is relevant to Australia’s refugee
population might assist to resolve some of the difficulties that refugees face in Australia.
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