{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T13:49:36Z","timestamp":1792590576316,"version":"4.5.0"},"reference-count":147,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2014,6,18]],"date-time":"2014-06-18T00:00:00Z","timestamp":1403049600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Br J Haematol"],"published-print":{"date-parts":[[2014,8]]},"abstract":"<jats:title>Summary of key recommendations<\/jats:title>\n                  <jats:p>\n                    <jats:list>\n                      <jats:list-item>\n                        <jats:p>The clinical picture is the most important factor in assessing the significance of test results assessing cobalamin status because there is no \u2018gold standard\u2019 test to define deficiency.<\/jats:p>\n                      <\/jats:list-item>\n                      <jats:list-item>\n                        <jats:p>Serum cobalamin currently remains the first\u2010line test, with additional second\u2010line plasma methylmalonic acid to help clarify uncertainties of underlying biochemical\/functional deficiencies. Serum holotranscobalamin has the potential as a first\u2010line test, but an indeterminate \u2018grey area\u2019 may still exist. Plasma homocysteine may be helpful as a second\u2010line test, but is less specific than methylmalonic acid. The availability of these second\u2010line tests is currently limited.<\/jats:p>\n                      <\/jats:list-item>\n                      <jats:list-item>\n                        <jats:p>Definitive cut\u2010off points to define clinical and subclinical deficiency states are not possible, given the variety of methodologies used and technical issues, and local reference ranges should be established.<\/jats:p>\n                      <\/jats:list-item>\n                      <jats:list-item>\n                        <jats:p>In the presence of discordance between the test result and strong clinical features of deficiency, treatment should not be delayed to avoid neurological impairment.<\/jats:p>\n                      <\/jats:list-item>\n                      <jats:list-item>\n                        <jats:p>Treatment of cobalamin deficiency is recommended in line with the British National Formulary. Oral therapy may be suitable and acceptable provided appropriate doses are taken and compliance is not an issue.<\/jats:p>\n                      <\/jats:list-item>\n                      <jats:list-item>\n                        <jats:p>Serum folate offers equivalent diagnostic capability to red cell folate and is the first\u2010line test of choice to assess folate status.<\/jats:p>\n                      <\/jats:list-item>\n                    <\/jats:list>\n                  <\/jats:p>","DOI":"10.1111\/bjh.12959","type":"journal-article","created":{"date-parts":[[2014,6,18]],"date-time":"2014-06-18T10:05:42Z","timestamp":1403085942000},"page":"496-513","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":449,"title":["Guidelines for the diagnosis and treatment of cobalamin and folate disorders"],"prefix":"10.1111","volume":"166","author":[{"given":"Vinod","family":"Devalia","sequence":"first","affiliation":[{"name":"Princess of 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