intrinsic-factor and Anemia--Hypochromic

Pernicious anemia appears classically by macrocytosis. We report a case of a late discovered Biermer disease, on a 42-year-old young black woman. The reason was an unusual aspect of this disease in a context of betathalassemia. The patient presented chronic anemia which evolved during about ten year. Biology showed a normocytosis and signs of hemolysis according to beta-thalassemia. This was confirmed by an electrophoresis showing 9.1 % of fraction F some haemoglobin. Since this date, the patient was treated by folic acid alone with periodic transfusions of red blood cell. She presented eight years after the beginning of her disease, neurological deterioration. Diagnosis of pernicious anemia was finally established up on histological gastritis, low level of the blood rate of vitamin B12, macrocytosis, and presence of intrinsic anti-factor and parietal anti-cells antibodies.

Topics: Adult; Anemia, Hypochromic; Anemia, Pernicious; Autoantibodies; Autoantigens; beta-Thalassemia; Combined Modality Therapy; Delayed Diagnosis; Disease Progression; Erythrocyte Transfusion; Female; Fetal Hemoglobin; Folic Acid; Humans; Intrinsic Factor; Iron Deficiencies; Paresthesia; Parietal Cells, Gastric; Vitamin B 12

Topics: Adult; Anemia, Hypochromic; Bone and Bones; Deficiency Diseases; Humans; Intestinal Absorption; Intrinsic Factor; Iodine; Iron; Neutron Activation Analysis; Potassium; Radiation Dosage; Radiation Protection; Vitamin B 12; Whole-Body Counting

Topics: Alcoholism; Anemia, Hypochromic; Anemia, Macrocytic; Anemia, Pernicious; Diagnosis, Differential; Folic Acid; Folic Acid Antagonists; Folic Acid Deficiency; Humans; Intestinal Absorption; Intrinsic Factor; Malabsorption Syndromes; Pyrimidine Nucleotides; Thymine Nucleotides; Uracil Nucleotides; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Anemia, Hypochromic; Anemia, Pernicious; Animals; Burns, Chemical; Celiac Disease; Diagnosis, Differential; Gastric Juice; Gastritis; Humans; In Vitro Techniques; Intrinsic Factor; Peptic Ulcer; Stomach Neoplasms; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Anemia; Anemia, Hypochromic; Anemia, Macrocytic; Female; Folic Acid Deficiency; Gastrectomy; Humans; Intestinal Absorption; Intrinsic Factor; Iron; Vitamin B 12 Deficiency

Topics: Anemia, Hypochromic; Anemia, Macrocytic; Carbohydrate Metabolism; Dumping Syndrome; Gastroenterostomy; Hematopoiesis; Humans; Intestinal Absorption; Intrinsic Factor; Iron; Malabsorption Syndromes; Methods; Postgastrectomy Syndromes; Protein-Losing Enteropathies; Vitamin B 12

To assess the prevalence and clinico-biologic characteristics of pernicious anaemia (PA) showing subtle or atypical onset.. One-hundred and twenty-four patients were found to fulfill criteria for PA (serum vitamin B12 deficiency due to absence of intrinsic factor secretion because of severe gastric atrophy). Of them were disclosed those lacking macrocytosis (MCV less than 98 fL), with or without anaemia (Hb less than 120 g/L in women and less than 14 f/L in men), but showing decreased serum B12 rates (less than 150 pmol/L).. Macrocytosis was absent in 15 out of the 124 cases (12.1%); either they had anaemia or not, serum B12 rates were decreased in all cases. Eight patients had concurrent iron deficiency, one had secondary anaemia, two had polycythaemia and four were normal from a haematological standpoint. Serum B12 assays were performed because of neuropsychiatric impairment (2 cases), polycythaemia study (3 cases), or positive anti-parietal cell antibodies found in an immunologic study (4 cases). The remaining patients were studied for chronic atrophy of the gastric mucosa (2 cases), and Plummer-Vinson syndrome, leucopenia and nutritional assessment (1 case of each condition).. Atypical presentation of pernicious anaemia, whose frequency is probably underestimated, was confirmed in our environment. This condition must be suspected and ruled out in patients with characteristics similar to those described above.

Topics: Anemia, Hypochromic; Anemia, Pernicious; Chronic Disease; Diagnosis, Differential; Gastritis, Atrophic; Humans; Intrinsic Factor; Iron Deficiencies; Polycythemia; Prevalence; Retrospective Studies; Vitamin B 12 Deficiency

Rats were rendered iron deficient by a combination of diet and bleeding to study its effects on vitamin B(12) absorption. Small intestinal loops were isolated in vivo and the absorption of -57Co-vitamin B(12) bound to a known quantity of intrinsic factor was measured. Iron deficiency resulted in the impairment of both uptake and transport of B(12). This malabsorption was corrected within 5 days by parenteral iron repletion. The findings were not due to a non-specific effect of anaemia since no correlation existed between haemoglobin levels and B(12) absorption in rats anaemic as a result of acute blood loss. No evidence was found for an altered small-intestinal microflora, bacterial counts being similar in iron-deficient and control rats. It is concluded that iron deficiency in the rat results in impaired absorption of B(12) by the small intestine, probably as a result of some defect produced in the enterocyte.

Topics: Acute Disease; Anemia, Hypochromic; Animals; Bacteria; Cobalt Radioisotopes; Female; Intestinal Absorption; Intestine, Small; Intrinsic Factor; Kidney; Liver; Rats; Vitamin B 12

Topics: Adult; Aged; Anemia, Hypochromic; Autoantibodies; Diabetes Mellitus; Female; Humans; Intrinsic Factor; Japan; Male; Middle Aged; Nuclear Warfare; Radiation Injuries; Stomach; Thyroid Diseases

Topics: Anemia; Anemia, Hypochromic; Anemia, Pernicious; Anemia, Sideroblastic; Blind Loop Syndrome; Crohn Disease; Diverticulitis; Folic Acid Deficiency; Gastritis; Gastrointestinal Diseases; Gastrointestinal Hemorrhage; Gastrointestinal Neoplasms; Humans; Intrinsic Factor; Malabsorption Syndromes; Vitamin B 12 Deficiency; Whipple Disease

Topics: Anemia, Hypochromic; Anemia, Pernicious; Ascorbic Acid; Female; Folic Acid; Humans; Intrinsic Factor; Iron; Male; Vitamin B 12

Topics: Achlorhydria; Anemia, Hypochromic; Anemia, Pernicious; Animals; Female; Gastric Juice; Gastric Mucosa; Hemoglobinometry; Hydrochloric Acid; Immune Sera; Intestinal Absorption; Intrinsic Factor; Iron; Iron Isotopes; Liver; Radiation Effects; Rats; Stomach

Topics: Anemia, Hemolytic; Anemia, Hemolytic, Autoimmune; Anemia, Hypochromic; Anemia, Macrocytic; Antibodies; Cell Survival; Cobalt Isotopes; Diagnosis, Differential; Erythrocytes; Feces; Female; Folic Acid; Gastric Juice; Hematologic Diseases; Hemorrhage; Humans; Intrinsic Factor; Iron; Iron Isotopes; Plasma Volume; Radioimmunoassay; Radioisotope Dilution Technique; Radioisotopes; Radionuclide Imaging; Schilling Test; Spleen; Vitamin B 12; Whole-Body Counting

Topics: Adult; Anemia, Hypochromic; Female; Humans; Intrinsic Factor; Postgastrectomy Syndromes

Topics: Anemia, Hypochromic; Cobalt Isotopes; Duodenal Ulcer; Female; Gastrectomy; Humans; Intrinsic Factor; Iron; Male; Peptic Ulcer; Postgastrectomy Syndromes; Schilling Test; Stomach Neoplasms; Vitamin B 12

Topics: Anemia, Hypochromic; Animals; Chromatography, Gel; Gastric Juice; Gastric Mucosa; Humans; Intrinsic Factor; Iron; Mucoproteins; Protein Binding; Spectrophotometry; Stomach; Swine

Topics: Achlorhydria; Adult; Age Factors; Aged; Anemia, Hypochromic; Anemia, Pernicious; Autoantibodies; Female; Fluorescent Antibody Technique; Gastric Acidity Determination; Gastric Juice; Gastric Mucosa; Humans; Intrinsic Factor; Male; Middle Aged; Pepsin A; Rheumatoid Factor; Sex Factors; Thyroid Gland; Vitamin B 12

Hemoglobin iron absorption in patients with treated prenicious anemia (PA) and concomitant iron deficiency was low compared to absorption in patients with iron deficiency alone. Crude and purified hog intrinsic factor (IF) concentrates doubled the absorption of hemoglobin iron in these patients as did normal (neutralized depepsinized) human gastric juice. Hemoglobin iron absorption was not significantly enhanced by PA gastric juice. Absorption of heme iron, like that of hemoglobin iron, was enhanced by normal neutralized depepsinized gastric juice. No enhancement of hemoglobin iron absorption by these substances was obtained in the normal or iron-deficient non-PA control subjects. Preincubation of the hog IF concentrate with antisera to IF significantly reduced the enhancement of hemoglobin iron absorption due to the concentrate. In vitro studies suggest that heme complexes with a substance present in IF-containing materials. Whether a gastric glycoprotein similar to IF serves as an intestinal transport factor for heme, similar to transport of vitamin B(12), or whether normal gastric juice acts by another mechanism cannot be determined at this time.

Topics: Anemia, Hypochromic; Anemia, Pernicious; Animals; Biological Transport; Chromatography, Gel; Gastrectomy; Gastric Juice; Heme; Hemoglobins; Humans; Immune Sera; Intestinal Absorption; Intrinsic Factor; Iron; Sheep; Swine

Topics: Adult; Anemia, Hypochromic; Anemia, Pernicious; Antigen-Antibody Reactions; Australia; Autoantibodies; Blood Donors; Complement Fixation Tests; Diabetes Mellitus; Female; Gastric Mucosa; Gastritis; Humans; Hyperthyroidism; India; Intrinsic Factor; Male; Middle Aged; North America; United Kingdom

Topics: Adult; Anemia, Hypochromic; Anemia, Pernicious; Antibodies; Australia; Diabetes Mellitus; Female; Humans; Hyperthyroidism; India; Intrinsic Factor; Male; Middle Aged; North America

Topics: Anemia, Hypochromic; Animals; Chromium Isotopes; Erythrocyte Count; Erythrocytes; Hemolysis; Hominidae; In Vitro Techniques; Intrinsic Factor; Iron Isotopes; Kinetics

Topics: Achlorhydria; Anemia, Hypochromic; Anemia, Pernicious; Gastric Mucosa; Gastrins; Humans; Intrinsic Factor; Peptic Ulcer; Peptides; Pylorus; Secretory Rate; Skin Tests; Vagotomy

Topics: Anemia, Hypochromic; Anemia, Pernicious; Fluorescent Antibody Technique; Gastric Juice; Histamine; Humans; Intrinsic Factor; Radionuclide Imaging; Technetium

Topics: Anemia, Hypochromic; Anemia, Pernicious; Antibodies; Antigen-Antibody Reactions; Cobalt Isotopes; Complement Fixation Tests; Diabetes Mellitus; Fluorescent Antibody Technique; Gastric Mucosa; Humans; Intrinsic Factor; Vitamin B 12

Topics: Aged; Anemia, Hypochromic; Anemia, Macrocytic; Gastrectomy; Humans; Intrinsic Factor; Iron; Male; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Anemia; Anemia, Hypochromic; Anemia, Macrocytic; Carbachol; Celiac Disease; Cobalt Isotopes; Colonic Neoplasms; Duodenal Ulcer; Folic Acid; Folic Acid Deficiency; Gastric Acidity Determination; Gastric Juice; Histamine; Humans; Insulin; Intrinsic Factor; Male; Pharmacology; Physiology; Sprue, Tropical; Vitamin B 12