vitamin-b-12 and Achlorhydria

Micronutrient deficiencies are relatively common, in particular iron and cobalamin deficiency, and may potentially lead to life-threatening clinical consequences when not promptly recognized and treated, especially in elderly patients. The stomach plays an important role in the homeostasis of some important hematopoietic micronutrients like iron and cobalamin, and probably in others equally important such as ascorbic acid, calcium, and magnesium. A key role is played by the corpus oxyntic mucosa composed of parietal cells whose main function is gastric acid secretion and intrinsic factor production. Gastric acid secretion is necessary for the digestion and absorption of cobalamin and the absorption of iron, calcium, and probably magnesium, and is also essential for the absorption, secretion, and activation of ascorbic acid. Several pathological conditions such as

Topics: Achlorhydria; Animals; Biomarkers; Bone Density; Calcium; Deficiency Diseases; Digestive System Surgical Procedures; Disease Management; Disease Susceptibility; Dysbiosis; Gastric Acid; Gastric Mucosa; Hemorrhage; Humans; Micronutrients; Stomach Diseases; Vitamin B 12; Vitamin B 12 Deficiency

Atrophic gastritis (AG) results most often from Helicobacter pylori (H. pylori) infection. AG is the most important single risk condition for gastric cancer that often leads to an acid-free or hypochlorhydric stomach. In the present paper, we suggest a rationale for noninvasive screening of AG with stomach-specific biomarkers.. The paper summarizes a set of data on application of the biomarkers and describes how the test results could be interpreted in practice.. In AG of the gastric corpus and fundus, the plasma levels of pepsinogen I and/or the pepsinogen I/pepsinogen II ratio are always low. The fasting level of gastrin-17 is high in AG limited to the corpus and fundus, but low or non-elevated if the AG occurs in both antrum and corpus. A low fasting level of G-17 is a sign of antral AG or indicates high intragastric acidity. Differentiation between antral AG and high intragastric acidity can be done by assaying the plasma G-17 before and after protein stimulation, or before and after administration of the proton pump inhibitors (PPI). Amidated G-17 will rise if the antral mucosa is normal in structure. H. pylori antibodies are a reliable indicator of helicobacter infection, even in patients with AG and hypochlorhydria.. Stomach-specific biomarkers provide information about the stomach health and about the function of stomach mucosa and are a noninvasive tool for diagnosis and screening of AG and acid-free stomach.

Topics: Achlorhydria; Antibodies, Bacterial; Biomarkers; Gastric Mucosa; Gastrins; Gastritis, Atrophic; Helicobacter Infections; Helicobacter pylori; Humans; Mass Screening; Pepsinogen A; Pepsinogen C; Stomach Neoplasms; Vitamin B 12

Pernicious anemia is a macrocytic anemia due to cobalamin deficiency, which is the result of intrinsic factor deficiency. Pernicious anemia is associated with atrophic body gastritis, whose diagnostic criteria are based on the histologic evidence of gastric body atrophy associated with hypochlorhydria. Serological markers suggesting the presence of oxyntic mucosa damage are increased levels of fasting gastrin and decreased levels of Pepsinogen I. Without the now obsolete Schilling's test, intrinsic factor deficiency may not be proven, and gastric intrinsic factor output after pentagastric stimulation has been proposed. Intrinsic factor autoantibodies are useful surrogate markers of pernicious anemia. The management of patients with pernicious anemia should focus on the life-long replacement treatment with cobalamin and the monitoring to early diagnose an eventual onset of iron deficiency. Moreover, these patients should be advised about possible gastrointestinal long-term consequences, such as gastric cancer and carcinoids.

Topics: Achlorhydria; Anemia, Pernicious; Carcinoid Tumor; Humans; Stomach Neoplasms; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Achlorhydria; Anemia, Pernicious; Humans; Ileal Diseases; Intestinal Absorption; Intestine, Small; Intrinsic Factor; Malabsorption Syndromes; Pancreatitis; Postgastrectomy Syndromes; Protein Binding; Transcobalamins; Vitamin B 12; Vitamin B Deficiency

Topics: Achlorhydria; Alcoholism; Avitaminosis; Bone Marrow; Bone Marrow Cells; Carbohydrate Metabolism; Chronic Disease; Ethanol; Humans; Intestinal Absorption; Intestinal Mucosa; Intestine, Small; Iron; Vitamin B 12

Topics: Achlorhydria; Anemia, Pernicious; Animals; Binding Sites; Biological Transport; Blind Loop Syndrome; Cestode Infections; Folic Acid Deficiency; Humans; Intestinal Absorption; Intestine, Small; Intrinsic Factor; Liver; Malabsorption Syndromes; Pancreas; Postgastrectomy Syndromes; Protein Binding; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Achlorhydria; Anemia, Macrocytic; Anemia, Pernicious; Child, Preschool; Gastric Juice; Humans; Male; Methods; Proteinuria; Vitamin B 12; Vitamin B 12 Deficiency

To investigate if patients with pernicious anaemia (PA) are prone to develop iron deficiency and if there is a difference for this manifestation between younger and older age groups.. Ninety-five patients with pernicious anaemia were evaluated for body iron status at the time of diagnosis and during follow up. Patients were also divided into two groups; younger than 60 (53 patients) and older than 60 (42 patients) years of age. Groups were compared for iron deficiency both at the time of diagnosis and at the end of follow up period.. Iron deficiency was a common finding in patients with pernicious anaemia. This deficiency state was more common in the elderly. During B12 therapy, iron deficiency increased in all groups, but the increased rate of iron deficiency was more prominent in the elderly patients.. Pernicious anaemia is an atrophic gastropathy in which gastric parietal cells no longer produce hydrochloric acid. These patients with achlorhydria demonstrate impaired absorption of iron. On the other hand, with ageing, gastric acidity is already diminished. Iron deficiency commonly accompanies patients with pernicious anaemia and this is more pronounced in the elderly group. We suggest that all patients with pernicious anaemia, especially the elderly, should be screened for iron deficiency both at the beginning and during the follow up.

Topics: Achlorhydria; Adolescent; Adult; Aged; Aged, 80 and over; Aging; Anemia, Pernicious; Female; Humans; Iron; Iron Deficiencies; Male; Middle Aged; Vitamin B 12

To investigate the effects of hypochlorhydria and acidic drink ingestion on protein-bound vitamin B12 absorption in elderly subjects.. Absorption of protein-bound vitamin B12 was examined in elderly normal subjects (n = 8), and in hypochlorhydric subjects due to omeprazole treatment (n = 8) or with atrophic gastritis (n = 3). Subjects underwent absorption tests of protein-bound vitamin B12 ingested with water, cranberry juice and 0.1 N hydrochloric acid.. Protein-bound vitamin B12 absorption was lower in the omeprazole-treated group (0.50%) compared to the normal group (1.21%; p < 0.001). With cranberry juice ingestion, the omeprazole-treated group showed an increase in absorbed protein-bound vitamin B12 (p = 0.025). With dilute hydrochloric acid ingestion, there was a further increase in vitamin B12 absorption (p < 0.001).. Omeprazole causes protein-bound vitamin B12 malabsorption, and ingestion of an acidic drink improves protein-bound vitamin B12 absorption.

Topics: Absorption; Achlorhydria; Administration, Oral; Aged; Aged, 80 and over; Female; Gastric Acid; Gastric Acidity Determination; Gastritis, Atrophic; Humans; Hydrochloric Acid; Hydrogen-Ion Concentration; Male; Omeprazole; Pepsinogens; Protein Binding; Radioimmunoassay; Vitamin B 12

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

Atrophic gastritis (AG) and use of proton pump inhibitors (PPIs) result in gastric acid suppression that can impair the absorption of vitamin B-12 from foods. The crystalline vitamin B-12 form, found in fortified foods, does not require gastric acid for its absorption and could thus be beneficial for older adults with hypochlorhydria, but evidence is lacking.. To investigate associations of AG and PPI use with vitamin B-12 status, and the potential protective role of fortified foods, in older adults.. Eligible participants (n = 3299) not using vitamin B-12 supplements were drawn from the Trinity-Ulster and Department of Agriculture cohort, a study of noninstitutionalized adults aged ≥60 y and recruited in 2008-2012. Vitamin B-12 status was measured using 4 biomarkers, and vitamin B-12 deficiency was defined as a combined indicator value < -0.5. A pepsinogen I:II ratio <3 was considered indicative of AG.. AG was identified in 15% of participants and associated with significantly lower serum total vitamin B-12 (P < 0.001) and plasma holotranscobalamin (holoTC; P < 0.001), and higher prevalence of vitamin B-12 deficiency (38%), compared with PPI users (21%) and controls (without AG and nonusers of PPIs; 15%; P < 0.001). PPI drugs were used (≥6 mo) by 37% of participants and were associated with lower holoTC concentrations, but only in participants taking higher doses (≥30 mg/d). Regular, compared with nonregular, consumption of fortified foods (i.e., ≥5 and 0-4 portions/wk, respectively) was associated with higher vitamin B-12 biomarkers in all participants, but inadequate to restore normal vitamin B-12 status in those with AG.. Older adults who have AG and/or use higher doses of PPIs are more likely to have indicators of vitamin B-12 deficiency. Fortified foods, if consumed regularly, were associated with enhanced vitamin B-12 status, but higher levels of added vitamin B-12 than currently provided could be warranted to optimize status in people with AG.

Topics: Achlorhydria; Aged; Aging; Biomarkers; Female; Food, Fortified; Gastritis, Atrophic; Humans; Male; Nutritional Status; Pepsinogens; Prevalence; Proton Pump Inhibitors; Vitamin B 12; Vitamin B 12 Deficiency; Vitamin B Complex

Pernicious anemia (PA) is characterized by vitamin B-12 deficiency and achlorhydria, both of which have a detrimental effect on bone strength. The principle aim of this study was to determine the risk of hip fracture in patients with PA.. This is a retrospective cohort study using the General Practice Research Database (GPRD) from the United Kingdom. GPRD data from May 1987 until April 2002 were utilized to identify patients between 40 and 90 years of age at the time of GPRD enrollment. The exposed group contained patients with a diagnosis of PA being treated with vitamin B-12 therapy. We matched each patient having a diagnosis of PA with 4 randomly selected non-PA patients with respect to age (+/-1 year) and sex. Cox regression analysis was used to determine the hazard ratio (HR) for hip fracture associated with PA.. Nine thousand five hundred six patients with a diagnosis of PA receiving vitamin B-12 injection therapy were identified and compared to 38,024 controls. Patients with PA had a greater risk of hip fracture than the controls (HR = 1.74; 95% CI: 1.45-2.08). The increase in hip fracture risk was even more pronounced among those patients newly diagnosed with PA during GPRD follow-up (HR = 2.63; 95% CI: 2.03-3.41).. Patients with a diagnosis of PA have an elevated risk of hip fracture. The increased hip fracture risk was persistent even years after vitamin B-12 therapy. Chronic achlorhydria could be the mechanism contributing to the persistently elevated hip fracture risk.

Topics: Achlorhydria; Adult; Aged; Aged, 80 and over; Anemia, Pernicious; Cohort Studies; Female; Hip Fractures; Humans; Male; Middle Aged; Proportional Hazards Models; Retrospective Studies; Risk; Vitamin B 12

Topics: Achlorhydria; Humans; Hydrochloric Acid; Malabsorption Syndromes; Vitamin B 12; Vitamin B 12 Deficiency

Long-term treatment with H(+)-K(+)-adenotriphosphatase (ATPase) inhibitors, such as omeprazole or lansoprazole, for severe gastroesophageal reflux disease is now widely used. Whether such treatment will result in vitamin B12 deficiency is controversial. We studied whether long-term treatment with omeprazole alters serum vitamin B12 levels in patients with Zollinger-Ellison syndrome.. In 131 consecutive patients treated with either omeprazole (n = 111) or histamine H2-receptor antagonists (n = 20), serum vitamin B12 and folate levels and complete blood counts were determined after acid secretion had been controlled for at least 6 months. These studies were repeated yearly. Serum vitamin B12 and folate levels were correlated with the type of antisecretory drug and the extent of inhibition of acid secretion.. The mean duration of omeprazole treatment was 4.5 years, and for H2-receptor antagonists 10 years. Vitamin B12 levels, but not serum folate levels or any hematological parameter, were significantly (P = 0.03) lower in patients treated with omeprazole, especially those with omeprazole-induced sustained hyposecretion (P = 0.0014) or complete achlorhydria (P < 0.0001). In 68 patients with two determinations at least 5 years apart, vitamin B12 levels decreased significantly (30%; P = 0.001) only in patients rendered achlorhydric. The duration of omeprazole treatment was inversely correlated with vitamin B12 levels (P = 0.013), but not folate levels. Eight patients (6%) developed subnormal B12 levels during follow-up.. Long-term omeprazole treatment leads to significant decreases in serum vitamin B12 but not folate levels. These results suggest patients with Zollinger-Ellison syndrome treated with H(+)-K(+)-ATPase inhibitors should have serum vitamin B12 levels monitored. Furthermore, these results raise the possibility that other patients treated chronically with H(+)-K(+)-ATPase inhibitors may develop B12 deficiency.

Topics: Achlorhydria; Adenosine Triphosphatases; Adolescent; Adult; Aged; Anti-Ulcer Agents; Drug Monitoring; Female; Folic Acid; Follow-Up Studies; Humans; Male; Middle Aged; Omeprazole; Time Factors; Vitamin B 12; Vitamin B 12 Deficiency; Zollinger-Ellison Syndrome

Neurologic damage may become permanent when the disorder is mistaken for multiple sclerosis or diabetic neuropathy--hence the need for prompt parenteral B12 in patients with pernicious anemia. The need for B12 injections is questionable for patients with achlorhydria and for those with a marginal or low serum B12 level but no signs or symptoms of deficiency.

Topics: Achlorhydria; Aged; Aged, 80 and over; Anemia, Megaloblastic; Anemia, Pernicious; Diagnosis, Differential; Female; Humans; Male; Middle Aged; Neurologic Examination; Peripheral Nervous System Diseases; Vitamin B 12; Vitamin B 12 Deficiency

Bacterial overgrowth of the small intestine commonly occurs in association with hypochlorhydria caused by atrophic gastritis or during treatment with omeprazole. The purpose of this study was to determine the clinical significance of bacterial overgrowth on small intestinal absorption and permeability and to evaluate the reliability of noninvasive breath tests to detect bacterial overgrowth in subjects with hypochlorhydria.. Seventeen healthy, elderly subjects with atrophic gastritis or omeprazole treatment (40 mg/day) and documented bacterial overgrowth were studied.. There was no evidence of fat malabsorption (72-hour fecal fat) or clinically significant carbohydrate malabsorption (25 g D-xylose and fecal pH) in any subject. The ratio of lactulose to mannitol excreted was normal in both atrophic gastritis and omeprazole-treated groups. Three subjects in each group had abnormally high alpha 1-antitrypsin clearances. Lactulose (10 g) and glucose (80 g) hydrogen breath tests were only abnormal in 1 out of 17 subjects, whereas the 1 g [14C]D-xylose test was abnormal in 6 out of 17 subjects.. Bacterial overgrowth caused by atrophic gastritis or omeprazole treatment is typically not associated with clinically significant fat or carbohydrate malabsorption. Noninvasive breath tests for bacterial overgrowth are not reliable in subjects with hypochlorhydria.

Topics: Achlorhydria; Aged; Bacteria; Carbohydrates; Colony-Forming Units Assay; Fats; Feces; Female; Gastritis; Humans; Intestinal Absorption; Lactulose; Male; Mannitol; Middle Aged; Omeprazole; Vitamin B 12; Xylose

Topics: Achlorhydria; Adenosine Deaminase; Anemia, Pernicious; Gastric Mucosa; Gastritis, Atrophic; Humans; Vitamin B 12

Ten cases of pernicious anaemia seen over a 15-year period (1973-1988) in a Lagos hospital are presented. Their ages ranged from 34 to 67 with a mean of 53.6 years. Females outnumbered males 6 to 4. Complications seen include gastric carcinoma, myelopathy, peripheral neuropathy, skin hyperpigmentation, hair depigmentation and diarrhoea. Reluctance to consider the diagnosis owing to firmly held notions of its rarity and a penchant for empirically treating chronic anaemias with all available haematinics and blood transfusion are probably contributory to its underdiagnosis. The fact that seven of the patients presented were seen in the last three years and three of them in the last one year raises the possibility of an increasing incidence of pernicious anaemia in Africans. The disease may be much less rare in Africans than once believed, and medical education should emphasize its existence and advocate greater care in the management of chronic anaemias.

Topics: Achlorhydria; Adult; Aged; Anemia, Pernicious; Autoantibodies; Autoimmune Diseases; Bone Marrow; Diagnosis, Differential; Fatigue; Female; Humans; Hydroxocobalamin; Incidence; Intrinsic Factor; Male; Middle Aged; Nigeria; Peripheral Nervous System Diseases; Pigmentation Disorders; Psychophysiologic Disorders; Retrospective Studies; Vitamin B 12; Vitamin B 12 Deficiency

The formation of a benign gastric ulcer in an achlorhydric milieu is a rare phenomenon. Since 1971, only 12 cases have been reported. Early cases were treated surgically for fear of gastric cancer, but since that time such ulcers have been successfully treated medically. The authors describe the case of a patient who had no concomitant ulcerogenic factors and whose ulcer occurred in the gastric cardia at the esophagogastric junction. We believe this is the first case report of a patient with pernicious anemia meeting these conditions.

Topics: Achlorhydria; Aged; Anemia, Pernicious; Female; Humans; Stomach Ulcer; Sucralfate; Vitamin B 12

Serum vitamin B12 concentrations were determined in 129 patients and a pentagastrin test performed in 116 patients with dermatitis herpetiformis (DH). Low serum vitamin B12 levels were found in 27 patients (21%) and achlorhydria in 30. Forty-two patients with achlorhydria and/or vitamin B12 deficiency were subjected to further haematological and gastrointestinal investigations. Functional or morphological involvement of the small intestine was seen in almost all patients with vitamin B12 deficiency but, in addition, atrophic gastritis resulting in defective secretion of intrinsic factor (pernicious anaemia) was found in 8 cases (7% of all DH patients). Thus, a low vitamin B12 level in DH patients should result in a careful gastrointestinal examination as both an atrophic gastritis and a coeliac-like enteropathy have further clinical implications.

Topics: Achlorhydria; Adult; Aged; Anemia, Pernicious; Dermatitis Herpetiformis; Female; Gastritis, Atrophic; Humans; Intestines; Male; Middle Aged; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Achlorhydria; Adult; False Negative Reactions; Female; Humans; Intestinal Absorption; Schilling Test; Vitamin B 12; Vitamin B 12 Deficiency

A prototype food-bound vitamin B12 (food-B12) absorption test has been developed in which 57Co-B12 was incorporated in vitro into egg yolk (yolk-B12) and served to volunteers in 50-g cooked portions together with toast and coffee for breakfast. Six hours later, 1 mg nonlabeled B12 was given intramuscularly and 24-hour urine was collected for radioactivity measurement. In separate tests, the absorption of yolk-B12 and crystalline 57Co-B12 was equally poor in patients with pernicious anemia. However, in patients with simple gastric achlorhydria and those who had undergone gastric surgery, the assimilation of yolk-B12 was impaired greatly, whereas the absorption of crystalline radio-B12 was normal. Egg yolk labeled with 58Co-B12 was administered together with crystalline 57Co-B12 in a dual isotope test with results similar to those obtained when the tests were prepared separately. This yolk-58Co-B12 test with its ability to detect malabsorption of food-B12 may be considered as an addition to the first part of the Schilling test.

Topics: Absorption; Achlorhydria; Anemia, Pernicious; Cobalt Radioisotopes; Egg White; Egg Yolk; Female; Gastric Mucosa; Humans; Schilling Test; Stomach; Vitamin B 12; Vitamin B 12 Deficiency

A longitudinal study of circulating autoantibodies in the sera of 48 BB rats was performed by indirect immunofluorescence. No pancreatic islet cell, adrenocortical, or thyroid microsomal autoantibodies were found. However, autoantibodies reactive to gastric parietal cells (PCA), smooth muscle, and thyroid colloidal antigens were identified, PCA were not detected in Wistar-Furth or BB x Wistar-Furth F1 hybrid rats. The range of ages at the time of first appearance of PCA was the same as that of onset of insulin-dependent diabetes (IDD) in the BB rats, suggesting that the processes leading to PCA and IDD were occurring at the same time of life in these animals. The presence of PCA was associated with degrees of lymphocytic gastritis and with squamous metaplasia of the gastric mucosa in the oldest BB rats (9 mo of age). Levels of serum iron and vitamin B12 did not differ between PCA-positive and PCA-negative BB rats, nor was achiorhydria found in any rat studied. The identification of PCA (and chronic gastritis) and other autoantibodies in the BB rat suggests that these animals have an underlying autoimmune diathesis. These findings thus provide indirect support for an autoimmune pathogenesis for IDD in the BB rat.

Topics: Achlorhydria; Aging; Animals; Autoantibodies; Diabetes Mellitus; Female; Fluorescent Antibody Technique; Gastric Mucosa; Humans; Iron; Male; Muscle, Smooth; Rats; Rats, Inbred Strains; Vitamin B 12

The frequency and significance of gastric parietal cell autoimmunity was assessed in 771 patients with insulin-dependent diabetes (IDD) of onset before 30 yr of age. Gastric parietal autoantibodies (PCA) were found 4 times more frequently in the patients with IDD (9%) than among 600 matched nondiabetic controls (2%). Caucasian female patients with IDD had PCA twice as frequently as male patients. Thyroid microsomal autoantibodies were more frequent in patients with IDD and PCA, than in those with IDD alone (Caucasian 46% versus 18%, black 25% versus 2.5%). A history of pernicious anemia and/or PCA was found in 25 or 40 families of IDD probands with PCA. Achlorhydria was demonstrated in 6 of 11 patients (54%) with PCA but in none of seven IDD patients without PCA. The six patients with achlorhydria had significantly lower uptakes of oral radiolabeled cobalamin, lower serum cobalamin levels, lower intrinsic factor-R protein ratios in their gastric aspirates, and lower plasma ferritin levels than patients with IDD but without PCA. None of the study group had IF antibodies in their serum or gastric juice. Overt pernicious anemia and neuropathy were found in one patient with PCA. Young patients with IDD at risk for atrophic gastritis and cobalamin deficiency can initially be identified by screening for PCA. Many of these young patients with PCA already have achlorhydria and evidence of decreased absorption of cobalamin. These patients can then be followed with cobalamin levels and/or with complete blood counts to identify those requiring therapy.

Topics: Achlorhydria; Adolescent; Adult; Anemia, Hypochromic; Autoantibodies; Child; Diabetes Mellitus, Type 1; Female; Ferritins; Humans; Male; Stomach; Vitamin B 12

Topics: Achlorhydria; Anemia, Pernicious; Animals; Feces; Fishes; Humans; Intestinal Absorption; Tissue Distribution; Trout; Vitamin B 12

Serum vitamin B12 concentration, parietal cell antibodies (PCA), peak acid output vitamin B12 resorption capacity were determined in 76 patients (age 23 to 82 years). Gastroscopy was performed on all of these patients; guided biopsy was taken from 70 of them. No influence of the inflammatory changes in the gastric mucosa, sex or the presence of PCA on the serum vitamin B12 concentration were demonstrable in our patients, who all revealed a vitamin B12 resorption in the normal range. In particular we were unable to confirm the observation of Döscherholmen et al. (5) of a fall in serum vitamin B12 concentration with increasing age or decreasing PAO. Hence the estimation of the serum vitamin B12 concentration cannot be used as a screening test for selecting those patients suffering from chronic atrophic gastritis and achlorhydria, who should be monitored by gastroscopy and biopsy because of an increased risk of gastric cancer.

Topics: Achlorhydria; Adult; Aged; Aging; Female; Gastric Juice; Gastritis; Gastritis, Atrophic; Humans; Male; Middle Aged; Regression Analysis; Vitamin B 12; Vitamin B 12 Deficiency

Thirteen persons with normal pentagastrin-stimulated gastric H+ secretion and 17 with achlorhydria were studied with a liquid test meal after an overnight fast. Blood was drawn before and every 30 min for 180 min after start of the meal. Serum gastrin, serum PG I, and serum vitamin B12 were determined by radioassay methods. Serum PG I was significantly lower in the achlorhydric subjects than in the normal secretors. The meal induced a slight and late rise in serum PG I in the control group. In contrast, the meal caused a slight fall in the achlorhydric persons. Basal serum gastrin was significantly higher in the achlorhydric group, in whom the meal also caused a significant fall in serum gastrin, which contrasts sharply with the rise in the control group. Although serum gastrin fell significantly in the achlorhydric group, a meal-induced rise in serum gastrin was observed in some of the achlorhydric subjects with basal serum gastrin below 100 pmol/l. Serum vitamin B12 was reduced in 8 of the 17 persons with achlorhydria, and in these 8 subjects serum PG I was significantly lower than in those with achlorhydria and normal serum vitamin B12.

Topics: Achlorhydria; Female; Food; Gastric Juice; Gastrins; Humans; Hydrogen-Ion Concentration; Male; Middle Aged; Pepsinogens; Vitamin B 12

Topics: Achlorhydria; Anemia, Pernicious; Gastric Juice; Hematinics; History, 20th Century; Humans; United States; Vitamin B 12

Chicken meat labeled in vivo with radio-B12 was ingested by normal volunteers. The absorption, measured by the fecal excretion method, was similar to that reported for crystalline radiocyanocobalamin and for mutton, but exceeded that from eggs. Parenteral injection of 1000 microgram of nonlabeled vitamin B12 did not interfere with the absorption of the radio-B12 from the meat. The urinary radioactivities, which were as low as those after oral administration of radioactive hydroxocobalamin and vitamin B12 coenzyme, suggested that the radio-B12 was present in meat in coenzyme form or was converted into the stable hydroxoform during the process of cooking and digestion. Patients with pernicious anemia showed insignificant urinary radioactivities in a standardized urinary excretion test using chicken meat whereas subjects with simple gastric achlorhydria and partial gastrectomy had subnormal values although their absorption of crystalline radiocyanocobalamin was normal. The subnormal serum vitamin B12 concentration seen in these latter subjects may, therefore, be due to impaired assimilation of vitamin B12 from food.

Topics: Achlorhydria; Anemia, Pernicious; Animals; Chickens; Cobamides; Feces; Gastrectomy; Humans; Meat; Stomach; Tissue Distribution; Vitamin B 12

During 1 year 725 consecutive patients admitted to a geriatric unit were investigated for anaemia. 51% of men had haemoglobin levels below 13.5 g/dl and 41% of women had levels below 12 g/dl. 657 patients had an azuresin tubeless test meal following an augmented dose of histamine acid phosphate and 450 (68%) had achlorhydria. Gastric biopsies were performed on 240 of the patients with achloryhdria and 201 satisfactory biopsies were obtained. These were graded into five categories: (1) normal; (2) surface gastritis; (3) diffuse gastritis; (4) chronic atrophic gastritis, and (5) chronic atrophic gastritis with intestinal metaplasia. The grades of mucosal change could not be correlated with the presence or absence of anaemia, the state of gastric function as measured by the Schilling test for absorption of vitamin B12, or the level of vitamin B12 in the serum.

Topics: Achlorhydria; Age Factors; Aged; Anemia; Female; Gastric Juice; Gastric Mucosa; Gastritis; Humans; Male; Schilling Test; Vitamin B 12

Topics: Achlorhydria; Adult; Agammaglobulinemia; Anemia, Hypochromic; Gastritis; Humans; Intestinal Absorption; Male; Vitamin B 12

Several haematological findings (especially the values of serum LDH and its isoenzymes) were compared with changes in the gastrin level in pernicious anaemia. While vitamin B12 substitution therapy led to normalization of the anaemia and of the enzyme levels, gastric atrophy and, hence, the elevation in serum gastrin levels remained unchanged. Determination of serum gastrin, therefore, provides a valuable tool for the verification of the diagnosis of pernicious anaemia in treated cases.

Topics: Achlorhydria; Anemia, Pernicious; Animals; Clinical Enzyme Tests; Gastrins; Humans; Isoenzymes; L-Lactate Dehydrogenase; Rabbits; Radioimmunoassay; Vitamin B 12

Forty-two patients with pernicious anemia (PA) and 35 patients with achlorhydria but without PA were investigated by means of serum gastrin determination and estimation of circulating parietal cell and thyroidal autoantibodies. In 38 of the 77 patients, gastroscopic and histopathological examinations of the antral and corpus mucosa were performed. The patient groups were similar with regard to distribution of high and normal serum gastrin levels, the frequencey of autoantibodies and antrum-sparing atrophic gastritis. In the present selection of patients, therefore, the achlorhydria group was supposed to represent a precursor state of the group with PA. A minor proportion of patients with severe atrophic gastritis of the antrum as well as of the corpus mucosa was found in the two groups.

Topics: Achlorhydria; Adult; Aged; Anemia, Pernicious; Autoantibodies; Female; Gastric Mucosa; Gastrins; Gastritis; Humans; Male; Middle Aged; Vitamin B 12

Topics: Achlorhydria; Adenoma, Islet Cell; Blood Glucose; Calcium; Dehydration; Diarrhea; Gastric Juice; Gastrointestinal Hormones; Humans; Hypokalemia; Pancreatic Juice; Pancreatic Neoplasms; Syndrome; Vitamin B 12

Idiopathic late-onset immunoglobulin deficiency in a young man was associated with achlorhydria and a severe intestinal malabsorption syndrome that did not respond to conventional therapy. Combined therapy with high doses of prednisone and tetracycline hydrochloride resulted in weight gain, cessation of diarrhea, improved absorption of water, fat, and vitamin B12, and production of gastric acid after stimulation with histamine. Serum immunoglobulin levels, however, did not increase.

Topics: Achlorhydria; Adult; Age Factors; Body Weight; Celiac Disease; Cholecystokinin; Diarrhea; Drug Therapy, Combination; Humans; Immunoglobulin M; Immunologic Deficiency Syndromes; Malabsorption Syndromes; Male; Prednisone; Tetracycline; Vitamin B 12

Topics: Achlorhydria; Adult; Aged; Anemia, Pernicious; Atrophy; Autoantibodies; Autoimmune Diseases; Female; Follow-Up Studies; Gastritis; Humans; Intrinsic Factor; Malabsorption Syndromes; Male; Middle Aged; Schilling Test; Time Factors; Vitamin B 12

Topics: Achlorhydria; Anemia, Pernicious; Autoantibodies; Autoimmune Diseases; Gastritis; Humans; Malabsorption Syndromes; Vitamin B 12

Topics: Achlorhydria; Adolescent; Adult; Age Factors; Anemia, Pernicious; Autoantibodies; Gastric Acidity Determination; Humans; Immunoglobulin A; Immunologic Deficiency Syndromes; Intrinsic Factor; Male; Middle Aged; Oral Manifestations; Pedigree; Schilling Test; Vitamin B 12

Topics: Achlorhydria; Anemia, Pernicious; Celiac Disease; Child; Eye Manifestations; Gastric Mucosa; Glossitis; Growth Disorders; Humans; Injections, Intramuscular; Intestinal Mucosa; Intrinsic Factor; Male; Neurologic Manifestations; Paresthesia; Skin Diseases; Skin Manifestations; Vitamin B 12; Vitiligo

Topics: Achlorhydria; Anemia, Megaloblastic; Anorexia Nervosa; Body Weight; Bone Marrow Cells; Celiac Disease; Diarrhea; Gastritis; Hemoglobinometry; Humans; Jejunum; Malabsorption Syndromes; Sprue, Tropical; Tetracycline; Vitamin B 12; Zimbabwe

Topics: Achlorhydria; Anemia, Pernicious; Animals; Cattle; Cobalt Radioisotopes; Diet Therapy; Erythropoiesis; Gastric Juice; Gastric Mucosa; History, 19th Century; History, 20th Century; Humans; Meat; Rats; Vitamin B 12

Topics: Achlorhydria; Adult; Aged; Anemia, Macrocytic; Anemia, Pernicious; Antibodies; Erythrocyte Count; Folic Acid; Histamine; Humans; Intrinsic Factor; Malabsorption Syndromes; Middle Aged; Pentagastrin; Reticulocytes; Schilling Test; South Africa; Stimulation, Chemical; Syndrome; Tetracycline; Vitamin B 12

Topics: Achlorhydria; Adult; Aged; Anemia, Pernicious; Animals; Biological Assay; Chickens; Cobalt Isotopes; Eggs; Euglena gracilis; Feces; Female; Food; Gastrectomy; Humans; Intestinal Absorption; Male; Middle Aged; Vitamin B 12

Topics: Achlorhydria; Anemia, Pernicious; Antibodies; Biopsy; Cobalt Isotopes; Complement Fixation Tests; Deficiency Diseases; Fats; Feces; Female; Folic Acid; Gastric Juice; Gastric Mucosa; Gastritis; Humans; India; Intestinal Absorption; Intrinsic Factor; Malabsorption Syndromes; Male; Middle Aged; Vitamin B 12; Xylose

Topics: Achlorhydria; Adolescent; Adult; Age Factors; Aged; Anemia, Pernicious; Antibodies; Autoantibodies; Autoimmune Diseases; Child, Preschool; Cobalt Isotopes; Female; Gastric Juice; Gastric Mucosa; Histamine; Humans; Hydrogen-Ion Concentration; Intrinsic Factor; Male; Middle Aged; Schilling Test; Sex Factors; Vitamin B 12; Vitiligo

Topics: Achlorhydria; Eggs; Gastrectomy; Gastric Mucosa; Humans; Intestinal Absorption; Vitamin B 12

Fasting gastrin levels in serum were measured in 49 patients with different types of chronic gastritis and in matched controls. In 15 patients with established pernicious anaemia the mean (+/- S.E. of mean) level of gastrin was greatly raised (699 +/- 99 pg/ml). In 17 patients with chronic atrophic gastritis, seropositive for parietal cell antibody but with adequate vitamin-B(12) absorption, the level was also raised (476 +/- 74 pg/ml). By contrast, in "simple" atrophic gastritis seronegative for parietal cell antibody the gastrin levels were significantly lower for both diffuse atrophic gastritis (129 +/- 31 pg/ml) and multifocal gastritis (14 +/- 4 pg/ml). These levels were similar to those in the controls (46 +/- 7 pg/ml).The mechanism of the raised gastrin levels remains uncertain, but neither achlorhydria nor in vivo action of the parietal cell antibody wholly accounted for the hypergastrinaemia.We conclude that hypergastrinaemia is characteristic of gastritis associated with autoimmune reactions to gastric antigens and pernicious anaemia and that a raised serum gastrin is a useful marker of the type of gastritis that tends to progress to the gastric lesion of pernicious anaemia. The findings suggest that this type of gastritis is an essentially different disease from "simple" atrophic gastritis, and the differences in gastrin levels may be due to sparing of the antral mucosa in the autoimmune type but not in "simple" gastritis.

Topics: Achlorhydria; Aged; Anemia, Pernicious; Antibodies; Antigens; Autoimmune Diseases; Chronic Disease; Female; Gastric Mucosa; Gastrins; Gastritis; Humans; Male; Middle Aged; Vitamin B 12

Topics: Achlorhydria; Anemia, Macrocytic; Anemia, Pernicious; Autoantibodies; Cobalt Isotopes; Folic Acid Deficiency; Gastric Juice; Humans; Intrinsic Factor; Radioimmunoassay; Vitamin B 12

Topics: Achlorhydria; Aged; Betaine; Citrates; Female; Humans; Hydrochloric Acid; Lactates; Male; Niacinamide; Pepsin A; Vitamin B 12; Vitamins

The effect of aspirin (acetylsalicylic acid) ingestion on occult gastrointestinal blood loss has been studied in patients with treated Addisonian pernicious anaemia and proved achlorhydria and in control patients able to secrete hydrochloric acid. A highly significant increase in gastrointestinal blood loss (1.9 ml./day of treatment) occurred with aspirin ingestion in the achlorhydric patients. The control group had a significantly greater increase in blood loss (4.29 ml./day of treatment). Thus aspirin can produce occult gastrointestinal blood loss by a mechanism unrelated to hydrochloric acid. Half of the control patients had losses of similar magnitude to those in the pernicious anaemia group, and the degree of blood loss in individual control patients appeared unrelated to gastric acidity. Differences in gastric mucosal characteristics, in the rate of gastric emptying, or in systemic effects of aspirin may explain the variation between individuals in the degree of occult gastrointestinal blood loss after aspirin.

Topics: Achlorhydria; Adult; Aged; Anemia, Pernicious; Aspirin; Bone Marrow Examination; Female; Fluorescent Antibody Technique; Folic Acid; Gastric Juice; Gastric Mucosa; Gastrointestinal Hemorrhage; Humans; Male; Middle Aged; Occult Blood; Vitamin B 12

Topics: Achlorhydria; Adult; Aged; Anemia, Macrocytic; Anemia, Pernicious; Antibodies; Cestode Infections; Cobalt Isotopes; Female; Gastric Juice; Humans; Intrinsic Factor; Male; Methods; Middle Aged; Schilling Test; Vitamin B 12

Topics: Achlorhydria; Anemia, Pernicious; Cobalt Isotopes; Diagnosis, Differential; Gastric Juice; Humans; Intestinal Absorption; Intrinsic Factor; Malabsorption Syndromes; Radiometry; Succinates; Vitamin B 12

Topics: Achlorhydria; Adolescent; Anemia, Pernicious; Atrophy; Biopsy; Erythrocyte Count; Gastric Mucosa; Gastritis; Hemoglobins; Humans; Male; Oral Manifestations; Radiography; Vitamin B 12

Topics: Achlorhydria; Adult; Aged; Anemia, Hemolytic; Blood Platelets; Blood Proteins; Erythrocyte Count; Female; Hemoglobins; Hemosiderosis; Humans; Iron; Leukocytes; Male; Middle Aged; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Achlorhydria; Adult; Anemia; Anemia, Hypochromic; Anemia, Macrocytic; Blood Cell Count; Female; Folic Acid; Gastric Acidity Determination; Hematocrit; Humans; Iron; Pregnancy; Pregnancy Complications, Hematologic; Thalassemia; Urine; Vitamin B 12

Topics: Achlorhydria; Dermatitis Herpetiformis; Gastritis; Humans; Malabsorption Syndromes; Pemphigus; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Achlorhydria; Adult; Agammaglobulinemia; Anemia, Pernicious; Antibodies; Arthritis, Rheumatoid; Atrophy; Autoimmune Diseases; Colitis, Ulcerative; Diarrhea; Female; Fluorescent Antibody Technique; gamma-Globulins; Gastric Mucosa; Gastritis; Giardiasis; Humans; Hypersensitivity; Hypersensitivity, Delayed; Infections; Intrinsic Factor; Male; Middle Aged; Vitamin B 12

Topics: Achlorhydria; Aged; Anemia, Pernicious; Antibody Formation; Autoantibodies; Female; Fluorescent Antibody Technique; Gastric Acidity Determination; Gastric Juice; Histamine Release; Humans; Intrinsic Factor; Male; Middle Aged; Schilling Test; Stomach Neoplasms; Vitamin B 12

Topics: Absorption; Achlorhydria; Anemia, Pernicious; Cobalt Isotopes; Diagnosis, Differential; Diet; Fasting; Gastrectomy; Humans; Intrinsic Factor; Malabsorption Syndromes; Methods; Radionuclide Imaging; Stomach; Vitamin B 12

Topics: Achlorhydria; Adult; Anemia, Pernicious; Diarrhea; Female; Hematocrit; Humans; Male; Middle Aged; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Achlorhydria; Anemia, Pernicious; Gastric Juice; Gastrins; Gastritis; Histamine; Humans; Intrinsic Factor; Radioimmunoassay; Schilling Test; Vitamin B 12

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

Topics: Achlorhydria; Anemia, Pernicious; Autoimmune Diseases; Gastritis; History, 19th Century; History, 20th Century; Intrinsic Factor; Prednisolone; Thyroid Diseases; Thyroiditis, Autoimmune; Vitamin B 12

Topics: Achlorhydria; Aged; Anemia, Pernicious; Animals; Antigen-Antibody Reactions; Atrophy; Biopsy; Diabetes Mellitus; Female; Fluorescent Antibody Technique; Gastric Juice; Gastric Mucosa; Gastritis; Humans; Immune Sera; Intrinsic Factor; Male; Middle Aged; Prednisolone; Rats; Regeneration; Reticulocytes; Schilling Test; Stomach; Stomach Diseases; Thyroiditis, Autoimmune; Vitamin B 12

Topics: Achlorhydria; Adult; Anemia, Hypochromic; Dextrans; Female; Gastric Acidity Determination; Humans; Hysterectomy; Iron-Dextran Complex; Menorrhagia; Schilling Test; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Achlorhydria; Adult; Aged; Anemia, Macrocytic; Anemia, Pernicious; Black People; Cobalt Isotopes; Female; Folic Acid Deficiency; Humans; Intrinsic Factor; Male; Middle Aged; Radiometry; Vitamin B 12; Vitamin B 12 Deficiency; White People

Topics: Achlorhydria; Adult; Aged; Anemia, Pernicious; Animals; Cattle; Cobalt Isotopes; Digestion; Female; Gastrectomy; Humans; In Vitro Techniques; Intestinal Absorption; Intrinsic Factor; Liver; Liver Extracts; Male; Middle Aged; Peptides; Rats; Swine; Vitamin B 12

This paper reports the results of estimating vitamin B(12) absorption by whole body counting in patients without known gastrointestinal disorder, and in patients with pernicious anaemia, idiopathic achlorhydria, achlorhydria following gastric operations, and various forms of small intestinal disease. Patients with pernicious anaemia absorbed less than 30% of the test dose; they could be distinguished from patients without gastrointestinal abnormality and from most achlorhydric patients who secreted more than 300 mg units of intrinsic factor in the post-histamine hour. Nevertheless, the wide range of normal absorption and the variable absorption from the normal gastrointestinal tract is emphasized and discussed. There is no relation between histamine-stimulated intrinsic factor production and vitamin B(12) absorption in patients with small intestinal disease.

Topics: Achlorhydria; Anemia, Pernicious; Cobalt Isotopes; Humans; Intestinal Absorption; Intestinal Diseases; Malabsorption Syndromes; Methods; Postgastrectomy Syndromes; Radiometry; Vitamin B 12

Topics: Achlorhydria; Biopsy; Carotenoids; Child; Digestive System; Disaccharides; Dithiazanine; Duodenum; Female; Folic Acid; Gastric Acidity Determination; Glucose Tolerance Test; Humans; Intestine, Small; Iron; Malabsorption Syndromes; Male; Massachusetts; Middle Aged; Schilling Test; Stomach; Strongyloidiasis; Thiabendazole; Vitamin B 12

Topics: Achlorhydria; Anemia, Macrocytic; Gastrins; Histamine; Humans; Intestinal Absorption; Intrinsic Factor; Malabsorption Syndromes; Radioimmunoassay; Stimulation, Chemical; Time Factors; Vitamin B 12

Topics: Achlorhydria; Adult; Anemia, Pernicious; Diagnosis, Differential; Gastric Juice; Gastritis; Histamine; Humans; Intrinsic Factor; Schilling Test; Vitamin B 12

Topics: Achlorhydria; Adult; Aged; Anemia, Macrocytic; Biopsy; Female; Humans; Liver; Male; Middle Aged; Postgastrectomy Syndromes; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Achlorhydria; Clostridium perfringens; Diarrhea; Digestive System; Enterobacteriaceae; Enterococcus faecalis; Feces; Gastrectomy; Gastric Acidity Determination; Gastroenterostomy; Humans; Intestine, Small; Jejunum; Lipids; Stomach; Vagotomy; Vitamin B 12

Topics: Achlorhydria; Betaine; Cellulose; Dentures; Humans; Liver Extracts; Mouth, Edentulous; Pepsin A; Quaternary Ammonium Compounds; Riboflavin; Stomatitis; Vitamin B 12

Topics: Achlorhydria; Adult; Aged; Anemia, Hypochromic; Anemia, Pernicious; Antibody Formation; Blood Proteins; Cobalt Isotopes; Humans; Middle Aged; Schilling Test; Vitamin B 12

Topics: Achlorhydria; Aged; Anemia, Macrocytic; Antibodies; Chemical Precipitation; Cobalt Isotopes; Electrophoresis; Gastric Juice; Humans; In Vitro Techniques; Intestinal Absorption; Intrinsic Factor; Jejunum; Male; Vitamin B 12

Topics: Achlorhydria; Anemia, Pernicious; Antibodies; Blood; Carotenoids; Humans; In Vitro Techniques; Intrinsic Factor; Malabsorption Syndromes; Schilling Test; Vitamin A; Vitamin B 12; Vitamin B 12 Deficiency; Xylose

Topics: Achlorhydria; Adolescent; Adult; Anemia, Pernicious; Antibodies; Biopsy; Blood; Child; Child, Preschool; Female; Gastric Juice; Gastritis; Humans; Hydrochloric Acid; In Vitro Techniques; Infant; Intrinsic Factor; Male; Stomach Diseases; Vitamin B 12

Topics: Achlorhydria; Anemia, Pernicious; Cobalt Isotopes; Gastric Juice; Humans; Immunoassay; Immunochemistry; In Vitro Techniques; Intrinsic Factor; Vitamin B 12

Topics: Achlorhydria; Gastrectomy; Humans; Neurologic Manifestations; Postoperative Care; Postoperative Complications; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Achlorhydria; Adult; Aged; Blood; Bone Marrow Examination; Diet; Female; Humans; In Vitro Techniques; Male; Paresthesia; Sensation; Vibration; Vitamin B 12

Topics: Achlorhydria; Adult; Aged; Ambulatory Care; Anemia, Hypochromic; Diet Therapy; Follow-Up Studies; Gastrectomy; Hemoglobinometry; Humans; Iron; Male; Middle Aged; Vitamin B 12

Topics: Achlorhydria; Anemia; Anemia, Hypochromic; Anemia, Iron-Deficiency; Autoantibodies; Autoimmune Diseases; Autoimmunity; Blood Chemical Analysis; Cobalt Isotopes; Fluorescent Antibody Technique; Humans; Schilling Test; Stomach; Urine; Vitamin B 12

Topics: Achlorhydria; Anemia; Ascorbic Acid; Blood Transfusion; Folic Acid; Geriatrics; Humans; Scurvy; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Achlorhydria; Anemia; Anemia, Hypochromic; Anemia, Pernicious; Atrophy; Blood Chemical Analysis; Cobalt Isotopes; Deglutition Disorders; Gastric Acidity Determination; Hemoglobinometry; Histamine; Humans; Iron; Middle Aged; Plummer-Vinson Syndrome; Schilling Test; Stomach; Urine; Vitamin B 12

Topics: Achlorhydria; Anemia; Anemia, Pernicious; Animals; Cobalt Isotopes; Electrophoresis; Gastrectomy; Gastric Juice; Gastric Mucosa; Guinea Pigs; Histamine; In Vitro Techniques; Intestinal Mucosa; Intrinsic Factor; Pathology; Peptic Ulcer; Rats; Research; Saliva; Stomach Neoplasms; Urine; Vagus Nerve; Vitamin B 12

Topics: Achlorhydria; Anemia; Anemia, Pernicious; Blood; Carbachol; Gastric Juice; Gastritis; Gastritis, Atrophic; Geriatrics; Histamine; Humans; Hydrochloric Acid; Intrinsic Factor; Pathology; Pharmacology; Vitamin B 12

Topics: Achlorhydria; Anemia; Anemia, Pernicious; Atrophy; Chemical Phenomena; Chemistry; Erythropoiesis; Gastric Juice; Gastric Mucosa; Gastritis; Gastrointestinal Hormones; Humans; Intrinsic Factor; Metabolism; Peptic Ulcer; Pharmacology; Physiology; Vitamin B 12

Topics: Absorption; Achlorhydria; Adolescent; Child; Cobalt Isotopes; Corrinoids; Diabetes Mellitus; Diabetic Neuropathies; Humans; Liver; Metabolism; Radioactivity; Radioisotopes; Radionuclide Imaging; Research; Vitamin B 12

Topics: Absorption; Achlorhydria; Animals; Cestode Infections; Diphyllobothriasis; Diphyllobothrium; Gastric Acidity Determination; Humans; Vitamin B 12

Topics: Achlorhydria; Anemia; Corrinoids; Gastrectomy; Hematinics; Humans; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Achlorhydria; Corrinoids; Humans; Intestines; Vitamin B 12

The Kay augmented histamine test has been used in a special study of 30 patients with pernicious anaemia and 136 other subjects suspected of having achlorhydria. The findings have been correlated with uropepsinogen excretion, serum levels of vitamin B(12), and gastric biopsy. The definition of achlorhydria is specially considered.

Topics: Achlorhydria; Anemia, Pernicious; Biopsy; Gastric Juice; Histamine; Humans; Vitamin B 12

Topics: Achlorhydria; Anemia; Anemia, Pernicious; Endopeptidases; Gastric Juice; Humans; Vitamin B 12

Topics: Achlorhydria; Aged; Anemia; Ascorbic Acid; Hematologic Diseases; Humans; Iron; Polycythemia Vera; Vitamin B 12

Topics: Achlorhydria; Anemia, Pernicious; Gastric Juice; Hematinics; Humans; Stomach Neoplasms; Vitamin B 12

Topics: Achlorhydria; Anemia; Anemia, Pernicious; Corrinoids; Gastrectomy; Gastric Juice; Hematinics; Humans; Intrinsic Factor; Radioactivity; Stomach; Urine; Vitamin B 12

Topics: Achlorhydria; Administration, Oral; Anemia; Anemia, Pernicious; Corrinoids; Gastric Juice; Hematinics; Humans; Intrinsic Factor; Vitamin B 12

Topics: Achlorhydria; Anemia; Corrinoids; Disease; Foot; Hand; Humans; Subacute Combined Degeneration; Vitamin B 12

Topics: Achlorhydria; Corrinoids; Hematinics; Humans; Myelitis; Vitamin B 12

Topics: Achlorhydria; Anemia; Anemia, Pernicious; Hematinics; Humans; Vitamin B 12; Vitamins

Topics: Achlorhydria; Anemia; Anemia, Pernicious; Food; Hematinics; Humans; Vitamin B 12