Responses After 4 Months of Therapy With Oral or Parenteral Cyanocobalamin
| . | Oral . | Parenteral . |
|---|---|---|
| MCV decreased ≥5 fL | 9/18 | 8/15 |
| Hematocrit increased ≥5% | 5/18 | 2/15 |
| Marked improvement or clearing of paresthesias, ataxia, or memory loss | 4/18 | 4/15 |
| Serum methylmalonic acid decreased to <3 SD above the mean in normal controls | 17/18 | 12/14* |
| Serum total homocysteine decreased to <3 SD above the mean in normal controls | 16/184-151 | 13/15 |
| Serum cobalamin >300 pg/mL at 4 mo | 18/18 | 7/144-153 |
| Serum cobalamin >200 pg/mL at 4 mo | 18/18 | 10/144-155 |
| . | Oral . | Parenteral . |
|---|---|---|
| MCV decreased ≥5 fL | 9/18 | 8/15 |
| Hematocrit increased ≥5% | 5/18 | 2/15 |
| Marked improvement or clearing of paresthesias, ataxia, or memory loss | 4/18 | 4/15 |
| Serum methylmalonic acid decreased to <3 SD above the mean in normal controls | 17/18 | 12/14* |
| Serum total homocysteine decreased to <3 SD above the mean in normal controls | 16/184-151 | 13/15 |
| Serum cobalamin >300 pg/mL at 4 mo | 18/18 | 7/144-153 |
| Serum cobalamin >200 pg/mL at 4 mo | 18/18 | 10/144-155 |
*In 1 patient (no. 33), the pretreatment methylmalonic acid level was not increased.
One responding patient (no. 2) required the addition of folic acid to normalize the serum homocysteine.
Comparing oral versus parenteral treatment, χ2 = 11.5;P < .001.
Comparing oral versus parenteral treatment, χ2 = 5.9;P < .03.