An Assessment of the Diagnostic and Prognostic Value of Serum Vitamin B12 Levels in Liver Disease.

Vitamin B12 is stored in the liver and raised serum levels of the vitamin, as assayed biologically, are present in a variety of liver disorders, particularly those accompanied by acute necrosis of liver cells. Kristensen (1956) suggested the use of serum vitamin B12 level as a liver function test and Rachmilewitz, Stein, Aronovitch, and Grossowicz (1958), finding raised levels in acute and chronic hepatitis and portal cirrhosis, state that this is a 'useful and specific test for the presence and degree of hepatocellular damage'. However, others have reported less consistent changes in the serum vitamin B12, particularly in chronic parenchymal liver disease (Table l) and raised levels have been found in extrahepatic biliary obstruction and when the liver is invaded by metastatic neoplasm. The purpose of this investigation was to assess the diagnostic significance of raised serum vitamin B12