tetracycline and Vitamin-B-12-Deficiency

The role of bacteria in the bioavailability of protein-bound vitamin B12 was examined in eight elderly subjects who had atrophic gastritis and in eight normal controls. On separate days and in random order, vitamin B12 absorption tests were performed using either radiolabeled crystalline or protein-bound vitamin B12. At the same time, bacterial samples were collected from the upper gastrointestinal tract. The tests and gastrointestinal aspirates were performed before and during tetracycline therapy. Crystalline vitamin B12 was absorbed to the same extent in the two study groups. Atrophic gastritis subjects absorbed significantly less protein-bound vitamin B12 than normal controls (mean +/- SEM, 0.7% +/- 0.2% vs. 1.9% +/- 0.5%, respectively). However, protein-bound vitamin B12 absorption in these subjects normalized after antibiotic therapy. These results suggest that the small amounts of vitamin B12 released from the protein binders is readily absorbed (as shown in vitro) and/or metabolized by bacteria.

Topics: Achlorhydria; Aged; Bacterial Infections; Biological Availability; Female; Gastritis, Atrophic; Humans; Intestinal Absorption; Male; Tetracycline; Transcobalamins; Vitamin B 12; Vitamin B 12 Deficiency

We report the case of a patient in the Psychiatric Department who complained of progressive impairment of cerebral functions consistent with dementia, diarrhea and fecal incontinence in the last few months. His medical history included a Billroth II gastrectomy for gastric ulcer. Biochemical tests detected cobalamin deficiency, without megaloblastic anemia, and an abnormal Schilling test that was not due to intrinsic factor deficiency. Once other causes of cobalamin deficiency were ruled out, we considered it as a deficiency disease due to blind loop syndrome. Treatment with parenteral vitamin B complex and long term oral antibiotic therapy allowed the complete and permanent resolution of neurologic and digestive symptoms. We consider this case to be interesting because it shows the existence of curable dementias and the usefulness of taking into account bacterial overgrowth, usually underestimated, as an entity that can produce a variety of disorders.

Topics: Administration, Oral; Anastomosis, Surgical; Anti-Bacterial Agents; Blind Loop Syndrome; Dementia; Gastrectomy; Humans; Jejunum; Male; Middle Aged; Tetracycline; Vitamin B 12; Vitamin B 12 Deficiency

The clinical course is described of a 69-year-old patient with a malabsorption syndrome since her stay in Indonesia. Besides chronic diarrhoea and weight loss she suffered from malnutrition and had partial villous atrophy. Coeliac disease was considered in the differential diagnosis but considering the endemic appearance of postinfectious tropical sprue (PTS) in Indonesia and the extreme vitamin B12 deficiency our patient experienced, PTS appeared more likely. A good response to the therapy prescribed for PTS confirmed the diagnosis.

Topics: Aged; Celiac Disease; Diagnosis, Differential; Female; Folic Acid; Humans; Jejunum; Sprue, Tropical; Tetracycline; Vitamin B 12; Vitamin B 12 Deficiency

The case of a young woman from Guadeloupe developing severe megaloblastic anemia is reported. She presented with fever and hemolysis (she had heterozygotic beta-thalassemia) after a six month history of diarrhea. She was shown to have folate deficiency, steatorrhea, vitamin K and B12 malabsorption. She responded well to intravenous folinic acid and tetracyclines. Diagnosis was based on the following criteria: a) no other cause of malabsorption was found despite a comprehensive inquiry, b) the pattern of the illness corresponded to the definition of disease. Three particular aspects are outlined: the acute onset, malabsorption of vitamin B12 requiring prolonged and combined treatment, and the unusual place in which the disease was contracted.

Topics: Adult; Anemia, Megaloblastic; Drug Therapy, Combination; Female; Folic Acid; Folic Acid Deficiency; Humans; Infusions, Parenteral; Sprue, Tropical; Tetracycline; Thalassemia; Vitamin B 12; Vitamin B 12 Deficiency; Vitamin K Deficiency; West Indies

Topics: Folic Acid Deficiency; Humans; Iron Deficiencies; Levamisole; Recurrence; Stomatitis, Aphthous; Tetracycline; Vitamin B 12 Deficiency

The various forms of aphthous stomatitis and Behcet syndrome share common signs that were discussed during a conference workshop. Four markers should be considered in determining the presence of these diseases: hematologic abnormalities, HLA, antibody responses, and immune complexes.

Topics: Animals; Autoimmune Diseases; Behcet Syndrome; Folic Acid Deficiency; Humans; Immunity, Cellular; Iron Deficiencies; Levamisole; Recurrence; Stomatitis, Aphthous; Tetracycline; Vitamin B 12 Deficiency

Topics: Administration, Oral; Adult; Anemia, Macrocytic; Anemia, Megaloblastic; Female; Humans; Intrinsic Factor; Peutz-Jeghers Syndrome; Tetracycline; Vitamin B 12 Deficiency

Topics: Antibodies; Bacteriological Techniques; Bile Acids and Salts; Cells, Cultured; Follow-Up Studies; Humans; Hydrochloric Acid; Ileum; Intestinal Absorption; Intestine, Small; Intrinsic Factor; Jejunum; Obesity; Schilling Test; Tetracycline; Time Factors; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Adult; Bile Acids and Salts; Biopsy; Blood Glucose; Duodenum; Escherichia coli; Female; Flatulence; Follow-Up Studies; Humans; Ileostomy; Insulin; Intestinal Absorption; Jejunum; Male; Obesity; Postoperative Complications; Tetracycline; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Anemia, Pernicious; Follow-Up Studies; Humans; Intestinal Absorption; Intestine, Small; Protein-Losing Enteropathies; Tetracycline; Vitamin B 12; Vitamin B 12 Deficiency; Xylose

Topics: Animals; Bacteria; Blind Loop Syndrome; Cobalt Isotopes; Culture Media; Gastric Juice; Intestinal Absorption; Intrinsic Factor; Jejunum; Malabsorption Syndromes; Male; Methods; Neomycin; Rats; Tetracycline; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Aged; Diverticulitis; Diverticulum; Escherichia coli; Folic Acid; Humans; Intestines; Jejunum; Male; Neomycin; Neuritis; Radiography; Spinal Cord Diseases; Tetracycline; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Anemia, Macrocytic; Bone Marrow Examination; Celiac Disease; Dumping Syndrome; Folic Acid Deficiency; Humans; Male; Middle Aged; Radiography; Tetracycline; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Anemia; Anemia, Macrocytic; Child; Cobalt Isotopes; Genetics, Medical; Hematinics; Humans; Infant; Metabolism; Prednisone; Proteinuria; Tetracycline; Urine; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Acrodermatitis; Humans; Iodoquinol; Male; Quinolines; Skin; Tetracycline; Vitamin B 12 Deficiency; Zinc