Remission Of Anemia Research Articles

Vitamin B12 and the megaloblastic development.

In patients with vitamin B(12) deficiency, phytohemagglutinin-stimulated cultured lymphocytes had little or no thymidylate synthetase activity. Ample activity was found in such lymphocytes from normal individuals and patients with folic acid deficiency or pernicious anemia in remission. It therefore appears that the megaloblastosis that is associated with vitamin B(12) deficiency is related to low thymidylate synthetase activity.

Increased agglutinability by anti-i of red cells in sideroblastic and megaloblastic anaemia.

Agglutinin titres have been performed using anti‐I and anti‐i cold antibodies on red cells from patients with sideroblastic, iron deficiency and megaloblastic anaemias, as well as on normal adult and cord blood red cells.Raised i antigen titres were found using the red cells of 13 of 15 patients with sideroblastic anaemia and of seven of eight patients with megaloblastic anaemia but in none of eight patients with iron deficiency anaemia and in one of 17 patients with megaloblastic anaemia in remission. Those patients who had an elevated i antigen titre usually also had an elevated I antigen titre.The raised i and I antigen titres of the red cells of a patient with pernicious anaemia were shown to decrease markedly within 3 months of the onset of B12 therapy, indicating that the alteration probably persists for the life‐span of the red cell but that the cause of the alteration is reversible once the underlying blood disorder is corrected.It is believed that disordered erythropoiesis results in membrane alterations which lead to the increased agglutinability, but the cause is not known. It does not appear that a shortened red cell maturation time is a necessary factor.

The ultrastructure of bone marrow histiocytes in megaloblastic anaemia and the anaemia of infection.

Summary. An electron‐microscopic study was made of the iron in the histiocytes in niegaloblastic anaemia and in the anaemia of infection. The particulate iron seen by Prussian Blue staining in the histiocytes in megaloblastic anaemia was demonstrated by electron microscopy to be bound in the vesicles, while the diffuse iron staining in the anaemia of infection was related to the free dispersion of iron‐containing particles in the cytoplasm of the histiocytes. The phagocytosis of erythroblasts at various stages of maturity occurred in cases of niegaloblastic anaemia and resulted in a picture showing every stage of degradation. Phagocytosis of erythroblasts by histiocytes was not seen in the marrows of patients with the anaemia of infection nor did it occur in niegaloblastic anaemia in remission.

Gastric histology and autoantibodies in pernicious anemia.

Abstract The gastric histology and occurrence of anti‐nuclear factors and circulating autoantibodies against intrinsic factor, parietal cell and thyroid cell cytoplasm and mitochondria were studied in 28 patients with Addisonian pernicious anemia in remission. The data were analysed with respect to relations between gastric histology, autoantibodies in serum, age and sex of patients, and duration of pernicious anemia.Intrinsic factor antibody was not found in patients with gastric atrophy, who had a slightly higher mean age than was found in the patients with atrophic gastritis.Parietal cell antibody was found in all patients below 60 years of age, but apart from these findings no clear‐cut relations could be derived from the data.The significance of the gastric autoantibodies is discussed. It is concluded that intrinsic factor antibody secreted into gastric juice may neutralise intrinsic factor, and that the production of this antibody may be the crucial factor in the evolution of overt pernicious anemia. So far no direct evidence has been produced to show that the gastric autoantibodies play a role in the pathogenesis of the gastric lesion.

SERUM PEPSINOGEN IN THE DIFFERENTIATION OF MEGALOBLASTIC ANAEMIA.

Serum pepsinogen levels have been compared in 40 patients with severe megaloblastic anaemia with those obtained from 62 normal subjects, and with levels in 20 patients with pernicious anaemia in remission, 46 patients with iron-deficiency anaemia, and 18 patients with a duodenal ulcer. The range in the normal subjects was 55 to 482 units per ml. It is suggested that a level of below 90 units per ml. should be regarded as indicative of gastric atrophy. It was found to be of value in the early differential diagnosis of severe megaloblastic anaemia. The estimation was found to be reproducible and can be carried out in a routine hospital laboratory.

Clinical Studies on Glucose Metabolism via the Pentose Phosphate Pathway in Human Erythrocytes

Abstract Glucose metabolism via the pintos phosphate pathway was studied by measuring accelerated O2 uptake of human erythrocytes in the presence of methylene blue. Erythrocyte 02 uptake was independent of age in 67 normal patients. Erythrocyte 02 uptake was increased in pernicious anemia in relapse and in 5 of 6 jaundiced patients but was normal in pernicious anemia in remission and in 20 cases of malignancies of various types. In the latter cases there was no correlation between erythrocyte 02 uptake and hemoglobin content or reticulocyte count.

IRON DEFICIENCY IN MONKEYS FED DIETS CONTAINING SOYBEAN PROTEIN.

SummaryAfter receiving purified diets containing isolated soybean protein for 2 to 7 months, young Rhesus monkeys (Macaca mulatta) became anemic. The erythrocytes were microcytic and hypochromic, serum iron concentrations were low and serum iron binding capacities were high. Iron therapy, either parenteral or oral, produced a prompt remission of anemia. Since these diets contain as much iron as other diets that are adequate in this respect, gastrointestinal absorption of Fe59 was evaluated in the presence of soybean protein and compared to Fe59 absorption in the presence of casein. Soybean protein caused a significant reduction in gastrointestinal absorption of Fe59.

Persistent Hyperchromic Erythrocytes in Pernicious Anaemia in Remission

Persistent Hyperchromic Erythrocytes in Pernicious Anaemia in Remission

Failure of oral therapy in the maintenance of pernicious anemia.

Introduction Oral administration of cyanocobalamin (vitamin B 12 ) and intrinsic factor derived from hog stomach is known to be effective in producing remissions in patients with pernicious anemia in relapse. However, the efficacy of maintenance therapy with such preparations has been more difficult to evaluate. Short-term studies have indicated that satisfactory remission can be maintained on an oral preparation containing both cyanocobalamin and intrinsic factor. 1 Likewise, massive oral doses of cyanocobalamin without intrinsic factor may maintain patients with pernicious anemia in remission. 2-4 Since it has been observed that it may take several months to years for some patients with pernicious anemia to relapse, evaluation of a treatment program should be based upon a long-term study. The purpose of the present report is to compare the effectiveness of an oral preparation with that of parenteral cyanocobalamin in the management of pernicious anemia over a three-year period. During the observation

Differentiation of macrocytic anemias and diagnosis of pernicious anemia and sprue in remission by accelerated measurement of hepatic uptake of radioactive Co60B12.

Excerpt The differential diagnosis of various types of macrocytic anemia often presents difficult clinical problems. Many cases of dietary folic acid or B12deficiency and sprue cannot be distinguis...

Clinical application of cobalt 60-labeled vitamin B12 urine test.

SCHILLING1 has observed that normal patients excrete definite amounts of radioactive substances in the urine after an oral dose of 2 microgm. of vitamin B12 labeled with cobalt60 and a parenteral "flushing" dose of 1000 microgm. of the nonradioactive vitamin B12. In contrast, patients with pernicious anemia in remission excrete no detectable radioactivity in the urine when the labeled vitamin is administered with water or boiled gastric juice. However, the simultaneous administration of active gastric juice with the oral dose of vitamin B12 labeled with cobalt60 results in easily detectable amounts of radioactive substances in the . . .

Metabolic interrelations between intrinsic factor and vit. B12. IV. Relative thermostability of some intrinsic factor preparations.

An assay of the intrinsic factor activity of native, acid gastric juices of humans by means of the scintillation measurements of the hepatic uptake of radioactive vit. B12 on patients with pernicious anemia in remission, has confirmed the thermolability of the human intrinsic factor and its destruction or inactivation by boiling at pH 1.2-1.4 for 30 minutes. Similar studies done on intrinsic factor concentrates from hog stomach revealed inactivation or destruction of its intrinsic factor activity by boiling in 1/10 normal HCl (pH about 1.2) for 30 minutes, but a relative heat stability of the same preparations, when boiled in water at a neutral pH of about 6.0. Therefore, the thermostability of some of the “intrinsic factor concentrates with vit. B12” from hog stomach, when boiled in water, is apparently not due to the prior combination with vit. B12 because it can also be demonstrated on concentrates boiled in water prior to addition of the vitamin.

Studies of prothrombin and proconvertin (SPCA); concentrations in plasma of patients with pernicious anemia in remission, treated with vitamin B12.

Studies of prothrombin and proconvertin (SPCA); concentrations in plasma of patients with pernicious anemia in remission, treated with vitamin B12.

Oral administration CO60 vitamin B12 in pernicious anemia.

Following oral administration of 1.0 μg of Co60 vit. B.12: 1. Seven normal persons excreted 12-59% of radioactive cobalt in the stool in 3-9 days. 2. No activity could be found in the urine of 2 normal subjects up to 8 days after ingestion of the vitamin. 3. Four patients with pernicious anemia in remission excreted 89-99% of the dose in the stool. 4. In 3 of these cases 2 mg of folic acid, 10 mg of folic acid for one week, 50 g of ventriculin, and 15 mg of intrinsic factor had no appreciable effect on the amount excreated. 5. In one case 2 mg of folic acid and 15 mg of intrinsic factor reduced the excretion of Co60 about 40%, and 50 g of ventriculin cut the fecal activity about 25%. 6. In 3 Patients 2 g of aureomycin for one week had no effect and 150 cc of neutralized normal gastric juice reduced the fecal activity about 30%.

COMPARISON OF VITAMIN B12 FROM LIVER AND FROM STREPTOMYCES GRISEUS IN THE TREATMENT OF PERNICIOUS ANEMIA

Abstract 1. A clinical remission in one case of pernicious anemia in relapse treated with 50 µg. of vitamin B12 from liver is reported; the patient was followed for 114 days after two doses of 25 µg. were given on successive days and a peak of 3,900,000 erythrocytes occurred on the eighty-sixth day. 2. Preliminary observations are reported in 2 patients with pernicious anemia in relapse treated with a vitamin B12 derived from Streptomyces griseus; the first patient who had no neurologic complaints received 32 µg. while the second was given two doses of 32 µg. each because of severe, subacute, combined degeneration. A good hematologic response and a satisfactory clinical remission occurred in both cases. There was definite improvement neurologically in the second case. 3. The administration of 32 µg. of vitamin B12 derived from Streptomyces griseus to each of 5 cases of pernicious anemia in remission resulted in minor subjective and objective improvement.

Researches on the Bone-Marrow Reticulocyte crisis of Pernicious Anemia in Remission

Researches on the Bone-Marrow Reticulocyte crisis of Pernicious Anemia in Remission