Evaluation of the relationship between vitamin B12 levels and acute phase reactants in pati̇ents with sepsis in the pediatric intensive care unit

Introduction and Purpose: Sepsis is one of the most common indications for hospitalization in pediatric intensive care units, with high treatment costs and the highest mortality rate. Early diagnosis and initiation of treatment is of great importance in sepsis patients. Therefore, finding new findings and markers is very important. Vitamin B12 is a vitamin that has important effects on protein, carbohydrate and fat metabolism, plays a cofactor role in enzymatic activities involved in DNA synthesis, and is necessary for cell proliferation and maturation. The aim of this study was to determine the clinical characteristics of pediatric patients with sepsis or highly probable sepsis in the pediatric intensive care unit of Dicle University and to evaluate the relationship between CRP, PCT levels and Vitamin B12 levels. Materials and Methods: This study included 34 patients (20 boys and 14 girls) who were followed up with the diagnosis of sepsis or severe sepsis in the Pediatric Intensive Care Unit of Dicle University Medical Faculty (DUTF) between January 2018 and September 2023. Demographic, clinical, physical examination and laboratory findings of living and deceased patients were compared. Results: When the demographic characteristics of the patients were analyzed, half of the patients were under one year of age. The presence of comorbidities in patient in terms of survival and mortality rates was found to be statistically significant between the groups ( p<0.001). The causative agent was isolated from the cultures performed in 64.7% of the patients. In our study, PCT levels were found to be higher in 31 patients (91.1%), CRP levels were found to be higher in 33 patients (97%), and the mean Vitamin B12 levels of deceased patients were higher than those of living patients. However, there was no statistically significant difference (p=0.71, p=0.22, p=1.00, respectively). Conclusion: Sepsis can be diagnosed with a number of laboratory tests and clinical evaluation. Since early diagnosis of sepsis is very important, some specific biomarkers have been developed and are frequently used in intensive care units. Although this study shows that Vitamin B12 is an important biomarker in the diagnosis of sepsis, in order for vitamin B12 to be widely used like other biomarkers, new prospective multicenter studies with more patients are needed. Keywords: pediatric intensive care unit, sepsis, Vitamin B12. acute phase reactant