Hyperhomocysteinemia may be related to genetic (cystathione β-synthase deficiency or thermolabile variant of MTHFR) or deficiencies of related B group vitamins.13 Severe hyperhomocysteinemia (>100 μmol/L) is most often caused by the cystathionine β-synthase deficiency.14 Mild or moderate hyperhomocysteinemia may result from a relative deficiency of folic acid and vitamin B12 and homozygosity for the common polymorphism in the (MTHFR) gene (677CT).14 None of our patients had severe hyperhomocysteinemia. Here, MTHFR is linked to hyperhomocysteinemia.