Vitamin B12 deficiency - why refugee patients are at high risk.

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.