Fig. 1From: Rapid healing of a patient with dramatic subacute combined degeneration of spinal cord: a case reportDiagnostic pathway to prove cobalamin deficiency. Up to now, no consensus exists about the best diagnostic pathway to prove cobalamin deficiency [7]. This pathway is a modification of recommendations made by Herrmann et al. [7]. MMA methylmalonic acid, holoTC holotranscobalamin. Limit values for MMA and holoTC specified here are in accordance with those of other authors [7, 24, 29, 32]. For follow-up we recommend the measurement of homocysteine (normal: 5.0–15.0 µmol/l; pathological threshold: >25 µmol/l) [28]Back to article page