Introduction Patients with Crohn’s Disease (CD) who frequently have ileal involvement are at increased risk of vitamin B12 deficiency. Vitamin B12 deficiency in patients with ulcerative colitis (UC) is not widely reported. The aim of our project is to assess the prevalence of vitamin B12 deficiency in patients with Crohn’s Disease and Ulcerative colitis and to identify risk factors associated with it.
Method As part of routine care, patients attending Inflammatory Bowel Disease (IBD) service at Birmingham Children’s Hospital undergo vitamin B12 assessment at least once a year. We included all patients with CD and UC diagnosed who had vitamin B12 measured between 2010–2015. Retrospective review of patient notes and laboratory results were done. Patients with serum vitamin B12 values<200 pmol/L were defined as vitamin B12 deficient as per local laboratory ranges. Disease remission was assessed by Physician Global Assessment (PGA).
Results In total 244 patients (157 with CD and 87 with UC) were included. 45/157 (29%) patients with CD had low vitamin B12 levels. 28/87 (32%) patients with UC had low vitamin B12 levels. In patients with Crohn’s disease, disease not being in remission was associated with vitamin B12 deficiency ( p<0.05). Ileal involvement, ileal resection or treatment with immunomodulators and biologics were not associated with vitamin B12 deficiency in children with CD in this cohort. In patients with UC, paradoxically microscopic non-specific inflammation of ileum was inversely associated with vitamin B12 deficiency. Vitamin B12 deficiency was more frequently seen in UC patients who had subtotal colectomy (p<0.05). Disease and treatment details of CD patients are summarised in Table 1.
Conclusion Prevalence of Vitamin B12 deficiency is high in patients with Crohn’s Disease and Ulcerative colitis. Vitamin B12 levels need to be checked in all patients with IBD rather than testing based on presence of risk factors.
Disclosure of Interest None Declared
- IBD nutrition
- Vitamin B12