Abstract
Because of several undesirable features of the widely used Schilling test, results of this test and plasma levels of cyanocobalamin Co 57 were compared in 111 patients. The plasma test resulted in good separation of values between normal subjects and patients with vitamin B12 absorption defects. One patient with malabsorption had an unexplained falsely normal plasma concentration. On the other hand, over 5% of normal and over 50% of uremic patients had false-positive results of the Schilling test and normal plasma levels. The plasma test is more helpful than the Schilling test for patients with renal insufficiency and mental disturbances. It is a helpful adjuvant to the Schilling test to avoid mistakes in interpretation and repetitive tests. However, because of the consequences of missing a diagnosis of vitamin B 12 deficiency, the plasma test cannot be recommended exclusively as a substitute for the urine test at this time.
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