Importance Of PLT/MCH Ratio to Differentiate Isolated B12 Deficiency From B12 Deficiency Combined with Other Causes

  • Asma Sheikh, Dr JSMU
  • Suresh Kumar JSMU
  • Zareen Irshad, Dr JSMU
  • Nadeem Nusrat Fazaia Medical College
  • Salma Perveen Jinnah Sindh Medical University
  • Sadaf Razzak JSMU
  • Syed Mehmood Hasan, Professor Jinnah Sindh Medical University
Keywords: Vitamin B12, MCV, PLT/MCH ratio

Abstract

Objective: To explore the importance of platelet/mean corpuscular haemoglobin ratio to distinguish between isolated B12 deficiency from combine B12 with iron or B12 with beta thalassaemia trait

Methodology: Two types of cases were selected including isolated B12 deficiency and B12 deficiency combined with iron deficiency or beta thalassemia trait. A total of 105 cases were included. Complete blood counts were done including red cell indices, serum ferritin and Hb electrophoresis. Two arms were compared with each other with a p value less than 0.05 considered as significant.

Results: Mixed deficiencies group of B12 showed decreased haemoglobin level, mean corpuscular volume, mean corpuscular haemoglobin,and mean corpuscular haemoglobin concentration and increased platelet count as compared to solo B12 deficient group. CBC indices indicated that PLT/MCH ratio parameter was higher in value in combined deficiencies as compared to B12 deficiency alone.

Conclusion: It was concluded that with the help of Platelet/mean corpuscular haemoglobin ratio and hemogram indices, we can distinguish simple B12 deficiency from complicated B12 with iron deficiency or beta thalassaemia trait on the basis of complete blood count. Physicians should keep in mind these indices and ratio to distinguish mixed deficiencies on routine blood count thus initiating timely further management.

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Published
2020-02-22