Probable deficiency of vitamin B12 with pernicious anemia in two patients with normal Schilling test.

Abstract

Case Reports1 August 1957PROBABLE DEFICIENCY OF VITAMIN B12 WITH "PERNICIOUS ANEMIA" IN TWO PATIENTS WITH NORMAL SCHILLING TESTTIMOTHY R. TALBOT JR., M.D., ALBERT F. TETREAULT, M.D.TIMOTHY R. TALBOT JR., M.D.Search for more papers by this author, ALBERT F. TETREAULT, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-47-2-338 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptPernicious anemia is due to the absence of intrinsic factor in the patient's gastric secretions, leading to an inability to absorb vitamin B12 present in the diet.1 We have recently observed two patients in whom all of the classic criteria for severe pernicious anemia were present, but in whom a normal ability to absorb vitamin B12 from the gastrointestinal tract was demonstrated by means of the absorption test employing cobalt60-labeled vitamin B12.2Both patients demonstrated the following symptoms and signs: glossitis, diarrhea, vomiting, mental disturbances, generalized progressive weakness, severe macrocytic anemia, thrombocytopenia, moderate leukopenia with hypersegmented polymorphonuclear leukocytes, a megaloblastic...Bibliography1. Castle WB: Observations on etiologic relationship of achylia gastrica to pernicious anemia. I. Effect of administration to patients with pernicious anemia of contents of normal human stomach recovered after ingestion of beef muscle, Am. J. M. Sc. 178: 748, 1929. CrossrefGoogle Scholar2. Schilling RF: Intrinsic factor studies. II. Effect of gastric juice on urinary excretion of radioactivity after oral administration of radioactive vitamin B12 , J. Lab. and Clin. Med. 42: 860, 1953. MedlineGoogle Scholar3. SchillingClatanoffKorst RFDVDR: Intrinsic factor studies. III. Further observations utilizing the urinary radioactivity test in subjects with achlorhydria, pernicious anemia or a total gastrectomy, J. Lab. and Clin. Med. 45: 926, 1955. MedlineGoogle Scholar4. DavidsonMurphyWatsonCastle CSJCJJWB: Comparison of the effects of massive blood transfusions and of liver extract in pernicious anemia, J. Clin. Investigation 25: 858, 1946. CrossrefGoogle Scholar5. Nittis S: Blood platelets in pernicious anemia after liver therapy, Ann. Int. Med. 4: 931, 1930-31. Google Scholar6. Talbot TR: Personal observations. Google Scholar7. MasonLeavell JDBS: The effect of transfusions of erythrocytes on untreated pernicious anemia, Blood 11: 632, 1956. CrossrefMedlineGoogle Scholar8. WintrobeCartwrightPalmerKuhnsSamuels MMGEJGWJLT: Effect of corticotrophin and cortisone on the blood in various disorders in man, Arch. Int. Med. 88: 310, 1951. CrossrefGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: *Received for publication November 6, 1956.From the Hematology Section of the Department of Medicine, and the Harrison Department of Surgical Research, University of Pennsylvania School of Medicine, and the Veterans Administration Hospital, Philadelphia, Pennsylvania.Requests for reprints should be addressed to Timothy R. Talbot, Jr., M.D., The Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia 4, Pennsylvania. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByPSYCHOLOGY OF LABORATORY ANIMALSORAL TREATMENT OF PERNICIOUS ANÆMIA 1 August 1957Volume 47, Issue 2Page: 338-346KeywordsAchlorhydriaAnemiaDiarrheaHematology and oncologyHospital medicineMegaloblastic anemiaNeutrophilsPernicious anemiaSigns and symptomsVomiting Issue Published: 1 August 1957 PDF DownloadLoading ...