Table 4. Changes in serum total... | American Society of Hematology

Table 4.

Changes in serum total homocysteine,S-adenosylmethionine, cysteine, and glutathione levels after therapy in 7 cobalamin-deficient patients with neurologic abnormalities

Patient	Abnormality		Day of Cbl therapy	tHcy level, μM	AdoMet level, nM	Cysteine level, μM	Cys-gly level, μM	GSH level, μM
Patient	CNS	Anemia	Day of Cbl therapy	tHcy level, μM	AdoMet level, nM	Cysteine level, μM	Cys-gly level, μM	GSH level, μM
1	Yes	Yes	Pretherapy	163.3	132.1	393	121.7	0.7
			> 90 days	13.5	117.3	245	98.6	2.9
2	Yes	Yes	Pretherapy	130.3	133.2	398	68.0	1.9
			2 days	27.4	113.9	NA	NA	NA
			12 days	15.3	139.8	181	69.1	8.0
			30 days	12.9	76.1	198	88.5	7.6
3	Yes	Yes	Pretherapy	181.5	125.6	540	98.3	2.4
			> 90 days	15.3	74.5	175	68.6	4.0
4	Yes	Yes	Pretherapy	136.2	126.5	NA	NA	NA
			> 90 days	9.0	95.1	165	82.3	9.2
5	Yes	No	Pretherapy	37.2	135.2	595	74.6	2.2
			Folate; 60 days^4-150	33.4^4-150	96.6^4-150	189^4-150	74.9^4-150	10.3^4-150
			30 days^4-151	9.4^4-151	56.6^4-151	189^4-151	74.4^4-151	10.4^4-151
6	Yes	Yes	Pretherapy	72.2	80.2	315	35.9	0.8
			2 days	25.1	113.2	NA	NA	NA
			22 days	19.9	136.5	195	64.1	2.4
7	Yes	No	Pretherapy	104.3	109.6	436	92.2	4.4
			> 90 days	16.3	122.5	190	73.7	5.3

Patient	Abnormality		Day of Cbl therapy	tHcy level, μM	AdoMet level, nM	Cysteine level, μM	Cys-gly level, μM	GSH level, μM
Patient	CNS	Anemia	Day of Cbl therapy	tHcy level, μM	AdoMet level, nM	Cysteine level, μM	Cys-gly level, μM	GSH level, μM
1	Yes	Yes	Pretherapy	163.3	132.1	393	121.7	0.7
			> 90 days	13.5	117.3	245	98.6	2.9
2	Yes	Yes	Pretherapy	130.3	133.2	398	68.0	1.9
			2 days	27.4	113.9	NA	NA	NA
			12 days	15.3	139.8	181	69.1	8.0
			30 days	12.9	76.1	198	88.5	7.6
3	Yes	Yes	Pretherapy	181.5	125.6	540	98.3	2.4
			> 90 days	15.3	74.5	175	68.6	4.0
4	Yes	Yes	Pretherapy	136.2	126.5	NA	NA	NA
			> 90 days	9.0	95.1	165	82.3	9.2
5	Yes	No	Pretherapy	37.2	135.2	595	74.6	2.2
			Folate; 60 days^4-150	33.4^4-150	96.6^4-150	189^4-150	74.9^4-150	10.3^4-150
			30 days^4-151	9.4^4-151	56.6^4-151	189^4-151	74.4^4-151	10.4^4-151
6	Yes	Yes	Pretherapy	72.2	80.2	315	35.9	0.8
			2 days	25.1	113.2	NA	NA	NA
			22 days	19.9	136.5	195	64.1	2.4
7	Yes	No	Pretherapy	104.3	109.6	436	92.2	4.4
			> 90 days	16.3	122.5	190	73.7	5.3

Methionine values did not change significantly or consistently with therapy and are not shown.

CNS indicates central nervous system; Cbl, cobalamin; and NA, not available. See Table 3 for other abbreviations.

F4-150

The patient was incorrectly treated for 60 days with folic acid instead of cobalamin.

F4-151

Results 30 days after folate was discontinued and parenteral cobalamin was begun.

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