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I would do nothing. A better example is looking for cancer in unprovoked DVT. Apart from a few simple tests no decrease in mortality or morbidity is found in doing extensive workup and the amount of harm in even doing tumour markets is greater than the benefit. Of course I would take a good history and physical and probably do a FIT. Everything else would be depending on symptoms. 

Elizabeth Mac Namara
Jewish General Hospital
Montreal



On Feb 25, 2015, at 06:02, Jordaan Marieke <[log in to unmask]> wrote:

Dear all

 

In the paper titled  “The pathophysiology of elevated vitamin B12 in clinical practice”  published in  Q J Med 2013; 106:505–515  various investigations are suggested if an unexplained high vitamin B12 level is found.

 

Beyond advising FBC, LFT and CRP how far would colleagues go to exclude a possible underlying malignant or non-malignant condition?

 

 

Regards

 

Marieke

 

Dr Marieke Jordaan

 

Consultant Chemical Pathologist / Head of Clinical Service, Pathology

Mid-Yorkshire Trust

 

Email: [log in to unmask]

Tel: (01924) 317060 or ext 57060

PA, Diane Blakeston: (01924) 317056 or ext 57056

 

 

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------ACB discussion List Information-------- This is an open discussion list for the academic and clinical community working in clinical biochemistry. Please note, archived messages are public and can be viewed via the internet. Views expressed are those of the individual and they are responsible for all message content. ACB Web Site http://www.acb.org.uk Green Laboratories Work http://www.laboratorymedicine.nhs.uk List Archives http://www.jiscmail.ac.uk/lists/ACB-CLIN-CHEM-GEN.html List Instructions (How to leave etc.) http://www.jiscmail.ac.uk/