Effect of Rat Intrinsic Factor on Vitamin B12 Absorption in Pernicious Anemia

Science ◽  
1957 ◽  
Vol 126 (3273) ◽  
pp. 558-558 ◽  
Author(s):  
J. ABELS ◽  
M. G. WOLDRING ◽  
J. J. M. VEGTER ◽  
H. O. NIEWEG
Keyword(s):  
Vitamin B12 ◽  
Pernicious Anemia ◽  
Intrinsic Factor ◽  
Vitamin B12 Absorption

scholarly journals Vitamin B12 Malabsorption Due to Intrinsic Factor Deficiency in Indian Subjects

Blood ◽  
1972 ◽  
Vol 40 (5) ◽  
pp. 747-753 ◽  
Author(s):  
H. G. Desai ◽  
F. P. Antia
Keyword(s):  
Vitamin B12 ◽  
Pernicious Anemia ◽  
Indian Population ◽  
Intrinsic Factor ◽  
Subacute Combined Degeneration ◽  
Factor Deficiency ◽  
Vitamin B12 Absorption ◽  
Intrinsic Factor Deficiency ◽  
Intrinsic Factor Antibody ◽  
Vitamin B12 Malabsorption

Abstract Sixteen patients (from Bombay) with severe vitamin B12 malabsorption due to intrinsic factor deficiency, presenting as subacute combined degeneration of the cord (7), tropical sprue (3), anemia (2), thyrotoxicosis (2), diabetes mellitus (1), and pain in the abdomen (1), are reported. The difficulties of establishing a definite diagnosis of pernicious anemia in Indian population are described. The lower incidence of circulating intrinsic factor antibody (IFA) in Indian patients with histamine-fast achlorhydria and poor vitamin B12 absorption is emphasized. The necessity of separating atrophic gastritis, with severely impaired vitamm B12 absorption, from pernicious anemia on the basis of absence or presence of IFA in serum and/or gastric juice cannot be overemphasized.

scholarly journals Total Body Counting in the Assessment of Vitamin B12 Absorption in Patients with Pernicious Anemia, Achlorhydria Without Pernicious Anemia and in Acid Secretors

Blood ◽  
1970 ◽  
Vol 36 (1) ◽  
pp. 20-27 ◽  
Author(s):  
W. J. IRVINE ◽  
D. R. CULLEN ◽  
LAURA SCARTH ◽  
J. D. SIMPSON ◽  
S. H. DAVIES
Keyword(s):  
Vitamin B12 ◽  
Pernicious Anemia ◽  
Intrinsic Factor ◽  
Body Counting ◽  
Acid Secreting ◽  
Vitamin B12 Absorption ◽  
Upper Level ◽  
Equivocal Result ◽  
Total Body ◽  
Cent Error

Abstract The absorption of 58Co-vitamin B12 was assessed by the method of total body counting in 25 patients with frank P.A., five with latent P.A., 47 with achlorhydria but without malabsorption of vitamin B12 and 47 acid-secreting patients. A total of 192 tests was done. With or without prior stimulation of intrinsic factor secretion by pentagastrin the upper level of absorption of vitamin B12 in patients with frank or latent P.A. was 25 per cent. Taking an equivocal result to be 21-25 per cent inclusive, the total body counting method was able to distinguish P.A. patients from those with achlorhydria without P.A. with 87 per cent accuracy and one per cent error and from non-P.A. achlorhydric patients and acid secretors combined with 91 per cent accuracy and 0.5 per cent error. Pentagastrin stimulation did not improve the separation between achlorhydric patients with and without P.A. but raised the lower limit of retention of vitamin B12 from 24 to 44 per cent in the acid secreting patients. The method of total body counting is recommended as a method of assessing vitamin B12 absorption.

scholarly journals Radioactive Vitamin B12 Absorption Studies: Results of Direct Measurement of Radioactivity in the Blood

Blood ◽  
1957 ◽  
Vol 12 (4) ◽  
pp. 336-346 ◽  
Author(s):  
ALFRED DOSCHERHOLMEN ◽  
PAUL S. HAGEN ◽  
MARGARET LIU
Keyword(s):  
Vitamin B12 ◽  
Pernicious Anemia ◽  
Intrinsic Factor ◽  
Test Dose ◽  
Absorption Studies ◽  
Vitamin B12 Absorption ◽  
Early Rise ◽  
Oral Doses ◽  
Peak Blood

Abstract A new method for the determination of the absorption of vitamin B12 has been described using measurement of radioactivity in the blood or plasma after the ingestion of physiologic test doses of Co60 labeled vitamin B12. Although doses of 1.0 µc. (0.92 µg. vitamin B12) gave higher counts, equally reliable results were obtained with 0.5 µc. (0.46 µg. vitamin B12). The radioactivity was found in the plasma portion of the blood. With this method it was possible to differentiate between all of nine patients with pernicious anemia and 36 control subjects. In non-pernicious anemia subjects and in pernicious anemia patients given intrinsic factor, there was a relatively delayed rise in the blood or plasma radioactivity until a peak was reached in the 8 to 12 hour interval after the ingestion of the test dose. This absorption curve was quite different from the early rise observed by others after massive oral doses of vitamin B12, indicating a different mode of absorption. Following the peak blood concentration the radioactivity gradually declined and small amounts usually persisted for as long as one week, quite different from the rapid disappearance after parenteral administration previously reported. This method appears valuable in the diagnosis of pernicious anemia and other vitamin B12 malabsorptive states, in the evaluation of intrinsic factor activity, and in studies of various aspects of the metabolism of vitamin B12.

scholarly journals Congenital Pernicious Anemia with Coexistent Transitory Intestinal Malabsorption of Vitamin B12

Blood ◽  
1967 ◽  
Vol 30 (4) ◽  
pp. 495-502 ◽  
Author(s):  
BEATRICE C. LAMPKIN ◽  
ALVIN M. MAUER
Keyword(s):  
Vitamin B12 ◽  
Pernicious Anemia ◽  
Intrinsic Factor ◽  
Vitamin B12 Deficiency ◽  
Gastric Fluid ◽  
Intestinal Malabsorption ◽  
Gastrointestinal Series ◽  
Schilling Test ◽  
B12 Deficiency ◽  
Vitamin B12 Absorption

Abstract Pernicious anemia with coexistent transitory intestinal malabsorption of vitamin B12 has been established in adults. In this report a child with congenital pernicious anemia was documented to have had transitory selective intestinal malabsorption of vitamin B12. The diagnosis of congenital pernicious anemia was established by the age of the patient, absence of intrinsic factor in gastric fluid, lack of antibodies to intrinsic factor and parietal cells, presence of HCl in gastric fluid, and normal gastric biopsy. The xylose excretion test, 72-hour fecal fat determination, upper gastrointestinal series, and biopsy of the jejunum were normal, but the Schilling test was abnormal with hog intrinsic factor of known potency on two occasions, indicating selective malabsorption of vitamin B12. Seven months after therapy the Schilling test was still abnormal without intrinsic factor, but was normal with both human and hog intrinsic factor. The normal absorption with intrinsic factor after therapy is indicative that the selective malabsorption which was originally present was probably a consequence of the vitamin B12 deficiency resulting from lack of intrinsic factor. In patients with abnormal radioactive vitamin B12 absorption tests with administration of intrinsic factor, coexistent pernicious anemia must be excluded by demonstration of intrinsic factor in gastric fluid.

scholarly journals The response to prednisolone in atrophic gastritis: a possible effect on non-intrinsic factor-mediated vitamin B12 absorption

Gut ◽  
1973 ◽  
Vol 14 (1) ◽  
pp. 13-19 ◽  
Author(s):  
R. G. Strickland ◽  
J. M. Fisher ◽  
K. Lewin ◽  
K. B. Taylor
Keyword(s):  
Vitamin B12 ◽  
Atrophic Gastritis ◽  
Intrinsic Factor ◽  
Vitamin B12 Absorption

scholarly journals Chronic Atrophic Gastritis with Negative Intrinsic Factor and Parietal Cell Antibody Presenting as a Severe Hemolytic Anemia

2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
G. F. Cittolin-Santos ◽  
S. Khalil ◽  
J. K. Bakos ◽  
K. Baker
Keyword(s):  
Vitamin B12 ◽  
Atrophic Gastritis ◽  
Pernicious Anemia ◽  
Hemolytic Anemia ◽  
Parietal Cell ◽  
Intrinsic Factor ◽  
Peripheral Blood Smear ◽  
Chronic Atrophic Gastritis ◽  
Cell Antibody ◽  
Parietal Cell Antibody

A 28-year-old Caucasian male with Hashimoto’s disease and vitiligo presented with two weeks of dizziness on exertion following pharyngitis which was treated with prednisone 40 mg by mouth once a day for five days. Initial workup revealed anemia, elevated lactate dehydrogenase (LDH), and low haptoglobin. He underwent workup for causes of hemolytic anemia which was remarkable for a peripheral blood smear with hypersegmented neutrophils and low vitamin B12 levels concerning for pernicious anemia. Parietal cell and intrinsic factor antibodies were negative, and he then underwent an esophagogastroduodenoscopy with biopsy. The biopsy was negative for Helicobacter pylori, and the immunohistochemical stains were suggestive of chronic atrophic gastritis. He was started on vitamin B12 1,000 mcg intramuscular injections daily. His hemoglobin, LDH, and haptoglobin normalized. Given the absence of the parietal cell antibody and intrinsic factor antibody, this is a rare case of seronegative pernicious anemia.

scholarly journals Absorption of Liver-bound Vitamin B12 in Relation to Intrinsic Factor

Blood ◽  
1968 ◽  
Vol 32 (2) ◽  
pp. 313-323 ◽  
Author(s):  
KUNIO OKUDA ◽  
ISAO TAKARA ◽  
TERUMI FUJII
Keyword(s):  
Vitamin B12 ◽  
Pernicious Anemia ◽  
Rat Liver ◽  
Intrinsic Factor ◽  
In Vitro Digestion ◽  
Enhanced Absorption ◽  
Biochemical Studies ◽  
Peptide Complexes ◽  
Liver Powder

Abstract Rat liver containing radioactive native B12 was prepared by repeated injections of 57Co-OH-B12, and absorption of liver B12 was measured in patients with pernicious anemia and in subjects without stomach, using physiologic doses. It was found that absorption of liver B12 was very poor, not superior to that of free OH-B12, and coadministration of IFC markedly enhanced absorption. In vitro digestion of rat liver with several enzymes, as determined from liberation of dialyzable radioactivity, suggested its easy digestibility. Biochemical studies of the dialyzable products of liver containing 57Co-B12 failed to demonstrate any detectable quantities of radioactivity other than free 57Co-OH-B12. A study in which cow liver powder mixed with a small quantity of 57Co-CN-B12 was fed to humans and digestion of liver was estimated from the reduction in absorption of radioactivity, indicated that most of the extractable liver B12 was liberated free in the intestine. Thus, no evidence has been obtained for the production of B12-peptide complexes from liver by digestion that require no IF for absorption.

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