Plasma Radioactivity following Oral Administration of 57Co-Labelled Vitamin B12

1968 ◽  
Vol 13 (12) ◽  
pp. 425-429 ◽  
Author(s):  
R. D. Finney ◽  
R. W. Payne
Keyword(s):  
Intrinsic Factor ◽  
Pernicious Anaemia ◽  
Test Dose ◽  
Normal Subjects ◽  
Vitamin B ◽  
Oral Test ◽  
Parenteral Dose ◽  
Schilling Test ◽  
Low Levels ◽  
Gastro Intestinal Tract

Levels of plasma radioactivity were measured 8 1/2 hours after an oral dose of 1 μg of 57Co-labelled vitamin B12. The oral test dose was followed after 2 hours by a large parenteral dose (1,000 μg) of non-radioactive vitamin B12. The results of this test have been compared with the results of the urinary excretion (Schilling test) in 14 normal subjects and in 14 patients suffering from pernicious anaemia (in 10 of whom the test was later repeated with added hog intrinsic factor). Very low levels of plasma radioactivity were found in patients suffering from pernicious anaemia (less than 0.21% of the administered dose per litre of plasma); much higher levels of radioactivity (more than 0.95% of administered radioactivity per litre of plasma) were found in normal subjects. Levels of plasma radioactivity approaching but not quite reaching the normal range were found in patients with pernicious anaemia when the test was repeated with the addition of hog intrinsic factor. It is concluded that this test provides a simple, rapid, semi-quantitative method of assessing the absorption of vitamin B12 from the gastro-intestinal tract. In our view, it is likely to supplant the Schilling test for routine use in a busy general hospital.

scholarly journals Sensorimotor Neuropathy and Abnormal Vitamin B12 Metabolism in Early HIV Infection

1995 ◽  
Vol 22 (1) ◽  
pp. 43-46 ◽  
Author(s):  
M. Veilleux ◽  
O. Paltiel ◽  
J. Falutz
Keyword(s):  
Hiv Infection ◽  
Complete Blood Count ◽  
Clinical Stage ◽  
Intrinsic Factor ◽  
Serum Vitamin ◽  
Vitamin B ◽  
Schilling Test ◽  
Advanced Stages ◽  
Skin Responses ◽  
Intrinsic Factor Antibody

ABSTRACT:Distal sensory peripheral neuropathy (DSPN) has been reported in 5 to 75% of patients with human immunodeficiency virus (HIV) infection, particularly in advanced stages of the disease. Twenty HIV seropositive patients were studied prospectively to determine the frequency of DSPN in clinical stage II and III of the HIV infection, and to investigate the role of vitamin B12 deficiency on the frequency of DSPN in HIV patients. All patients had complete blood count, serum vitamin B12 level, anti-intrinsic factor antibody, Schilling test, and electrodiagnostic studies including nerve conduction studies and concentric needle examination in the lower extremities, and sympathetic skin responses. Only 1 patient (5%) had clinical and electrophysiological evidence of possible DSPN. Of the 6 patients with abnormal Schilling test, only one had DSPN based on distal sensory symptoms, abnormal neurological examination and electrodiagnostic studies. Evidence for possible DSPN was present in 5% of patients with early HIV infection and did not appear to be more frequent in patients with concurrent vitamin B12 deficiency.

Long-Term Clearance of [57Co]Cyanocobalamin in Vegans and Pernicious Anaemia

1980 ◽  
Vol 58 (1) ◽  
pp. 101-103 ◽  
Author(s):  
S. Amin ◽  
T. Spinks ◽  
A. Ranicar ◽  
M. D. Short ◽  
A. V. Hoffbrand
Keyword(s):  
Intrinsic Factor ◽  
Pernicious Anaemia ◽  
Normal Subjects ◽  
Whole Body ◽  
Least Squares Fit ◽  
Significant Difference ◽  
Maximum Period ◽  
Body Counting ◽  
Whole Body Counting

1. Whole-body counting has been used to monitor the clearance of [57Co]cyanocobalamin in normal subjects, vegans and patients with pernicious anaemia. After oral administration of 57Colabelled cyanocobalamin (1 μg/l μCi), subjects were counted for radioactivity monthly for a maximum period of 1 year. 2. The results obtained were consistent with a monoexponential clearance model and a least-squares fit showed that there was no significant difference between the mean clearance rates for the vegans and normal subjects. 3. The patients with pernicious anaemia cleared the vitamin significantly more quickly than the normal control subjects. 4. This may be due to failure to reabsorb biliary vitamin B12 in pernicious anaemia because of the absence of intrinsic factor.

Vitamin B12 absorption in rats, studied by a ‘loop’ technique

1960 ◽  
Vol 199 (1) ◽  
pp. 84-90 ◽  
Author(s):  
Kunio Okuda
Keyword(s):  
Intrinsic Factor ◽  
Quantitative Relationship ◽  
Test Dose ◽  
Vitamin B ◽  
High Dose ◽  
Intestinal Loop ◽  
Vitamin B12 Absorption ◽  
Physiological Dose ◽  
Binding Power ◽  
Site Of Absorption

A technique to prepare an intestinal loop in situ in rats is described for the study of the effect of intrinsic factor (IF) on the absorption of vitamin B12 and of the site of absorption. It was found that a) the site of absorption of vitamin B12 is the smal intestine and, particularly, the middle portion; b) a saline extract of rat stomach mucosa, as well as rat gastric juice, when mixed with a low test dose of vitamin B12, markedly increased the absorption of vitamin B12 by the loop. A quantitative relationship was demonstrated between absorption and vitamin B12-binding power of such an extract. However, a purified hog IF did not enhance the absorption of vitamin B12 and c) two different mechanisms for the absorption of vitamin B12 are suggested. One operates when a small physiological dose is administered; the absorption can be enhanced by co-administration of IF and be inhibited by ethylenediaminetetraacetate (EDTA). The other operates when a high dose is given; the absorption under such conditions is not affected either way by the administration of IF or EDTA.

scholarly journals Prospective evaluation of protein bound vitamin B12(cobalamin) malabsorption in the elderly using trout flesh labelled in vivo with 57Co-cobalamin

Gut ◽  
1997 ◽  
Vol 41 (4) ◽  
pp. 475-479 ◽  
Author(s):  
I Aimone-Gastin ◽  
H Pierson ◽  
C Jeandel ◽  
J P Bronowicki ◽  
F Plénat ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Pancreatic Insufficiency ◽  
Intrinsic Factor ◽  
Elderly Subjects ◽  
Blood Levels ◽  
Vitamin B ◽  
Healthy Elderly ◽  
Schilling Test ◽  
Hospitalised Patients

Background—The frequency of dietary protein bound vitamin B12 malabsorption in elderly patients remains controversial.Aims—To evaluate this malabsorption in elderly hospitalised patients using a modified Schilling test.Patients—Fourteen elderly patients with low B12 blood levels were prospectively selected from 394 hospitalised patients.Methods—The modified Schilling test was performed with trout labelled in vivo.Results—The test was normal in five healthy elderly subjects, in 7/8 patients with pancreatic insufficiency, and in nine non-elderly patients with antral gastritis. The low decision limit was established at 3.3% (median 4.8%). From the 14 elderly patients with low B12 prospectively selected from 394 hospitalised patients, seven had a real deficiency with anaemia and an increased homocysteine and/or methylmalonate serum level. The modified Schilling test showed malabsorption in five of these patients, including two in which the standard Schilling test was normal, and three in which the standard Schilling test was partially corrected by an intrinsic factor.Conclusions—Protein bound vitamin B12malabsorption was detected in at least 0.5% of elderly hospitalised patients, using the labelled trout flesh absorption test.

Autoimmune gastritis concomitant with gastric adenoma and subacute combined degeneration of the spinal cord

2021 ◽  
Vol 14 (5) ◽  
pp. e242836
Author(s):  
Masahiro Taniguchi ◽  
Gota Sudo ◽  
Yuzufumi Sekiguchi ◽  
Hiroshi Nakase
Keyword(s):  
Spinal Cord ◽  
Histopathological Examination ◽  
Intrinsic Factor ◽  
Pernicious Anaemia ◽  
Autoimmune Gastritis ◽  
Gastric Neoplasms ◽  
Gastric Body ◽  
Vitamin B ◽  
Gastric Adenoma ◽  
Subacute Combined Degeneration

A 62-year-old woman was referred to our department for further investigation of anaemia. Blood test showed macrocytic anaemia. Oesophagogastroduodenoscopy (OGD) revealed proximal-predominant gastric atrophy and flat elevated lesion in the gastric body. Several days after OGD, she complained of gait disturbance and was diagnosed with subacute combined degeneration of the spinal cord. Furthermore, laboratory tests showed positive for both anti-parietal cell and anti-intrinsic factor antibodies, as well as increased serum gastrin level and decreased pepsinogen I level, which confirmed the diagnosis of autoimmune gastritis (AIG). Anaemia and neurological symptoms were improved after vitamin B12 supplementation. Subsequently, the patient underwent gastric endoscopic submucosal dissection; histopathological examination revealed gastric adenoma. AIG can cause gastric neoplasms and vitamin B12 deficiency, with the latter resulting in pernicious anaemia and neurological disorders. These diseases are treatable but potentially life-threatening. This case highlights the importance of early diagnosis of AIG and proper management of its comorbidities.

scholarly journals Some observations on the possible nutritional significance of vitamin B12-and folate-binding proteins in milk. Absorption of [58Co] cyanocobalamin by suckling piglets

1975 ◽  
Vol 34 (3) ◽  
pp. 469-492 ◽  
Author(s):  
J. E. Ford ◽  
K. J. Scott ◽  
B. F. Sansom ◽  
P. J. Taylor
Keyword(s):  
Binding Capacity ◽  
Intrinsic Factor ◽  
Test Dose ◽  
The Body ◽  
Intact Protein ◽  
Vitamin B ◽  
Virtual Absence ◽  
Large Numbers ◽  
Suckling Piglets ◽  
Folate Binding Proteins

1. A study was made of the absorption of [58Co]cyanocobalamin in suckling piglets. Cyanocobalamin given at birth and at 7 d of age was efficiently absorbed from the intestine and retained within the body, mostly in the liver. A 10 μg test dose was absorbed no less efficiently than 0.5 μg, despite the virtual absence of intrinsic factor in the gut. In piglets given a 10 μg test dose at different ages between 0.5 and 56 d, there was a marked decrease in the efficiency of retention between about 7 and 21 d of age.2. Vitamin B12-binding capacity in the gastric mucosa increased with age, from 40 ng at birth to about 2000 ng at 14 d and 7000 ng at 35 d. This binder-protein was largely endogenous, whereas much of the unsaturated binder-protein in intestinal mucosa was apparently derived from milk.3. The chyme in the stomach and small intestine contained unsaturated binder-protein, partly endogenous and partly deriving from milk, which prevented uptake of added [G-3H]-cyanocobalamin into the ‘solids’ phase of the intestinal contents. The intestinal chyme contained large numbers (log10 7.0–9.1/ml) of bacteria, some of which were isolated and shown to take up cyanocobalamin or folic acid or both.4. The findings are discussed in relation to the concept that for some days or weeks after the cessation of transport of intact protein across the neonatal gut epithelium (‘closure’), protein-bound vitamins may continue to be taken up into the epithelial cells and there released for transport into the circulation. It is concluded that unsaturated vitamin-binders may strongly influence the ecology of the intestinal microflora.

Hydroxocobalamin and cyanocobalamin

1966 ◽  
Vol 4 (3) ◽  
pp. 11-12
Keyword(s):  
Gastric Carcinoma ◽  
Oral Therapy ◽  
Bacterial Flora ◽  
Intrinsic Factor ◽  
Pernicious Anaemia ◽  
Gastric Surgery ◽  
Vitamin B ◽  
Diphyllobothrium Latum ◽  
Temperate Climates

In temperate climates deficiency of vitamin B12 is usually due to defective absorption, most commonly from lack of intrinsic factor as in Addisonian pernicious anaemia and after gastric surgery; occasionally the absorptive defect is caused by gastric carcinoma, resection, short-circuiting or disease of the ileum, including an abnormal bacterial flora, or by the fish tapeworm (Diphyllobothrium latum). The effectiveness of oral therapy remains debatable,1 and, since the absorptive defect can rarely be corrected, injections of vitamin B12 are virtually essential.

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