vitamin-b-12 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; Aged; Anemia, Hypochromic; Anemia, Macrocytic; Anemia, Megaloblastic; Anemia, Pernicious; Child; Child, Preschool; Demyelinating Diseases; Diagnosis, Differential; Female; Folic Acid; Folic Acid Deficiency; Humans; Infant; Middle Aged; Pregnancy; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Anemia, Hypochromic; Humans; Iron; Oxidative Phosphorylation; Riboflavin; Riboflavin Deficiency; Succinate Dehydrogenase; Vitamin B 12; Vitamin B 12 Deficiency

A review of nutritional anaemia in Africa is presented above. It has been noted that nutritional anaemia, including iron-deficiency anaemia, megaloblastic anaemia due to folate deficiency or vitamin B12 deficiency, or both, and protein deficiency-anaemia, is widespread throughout Africa. It is particularly common in growing children, women of child-bearing age, pregnant women and lactating mothers. The anaemia is also especially common during the second half of the dry season and the first half of the wet season, when food supplies are limited. In all cases the anaemia is caused either by limited dietary intake, excessive loss of nutrients or excessive utilization. The anaemia is associated with a number of sequelae including both structural changes, like mitochondrial swelling and mucosal atrophy, and functional abnormalities, such as cardiac failure, decreased work output, increased pregnancy risks and increased susceptibility to infections. The evidence in favour of increased susceptibility to infections in megaloblastic anaemia and protein-deficiency anaemia is overwhelming, but in iron-deficiency anaemia the available information argues in favour of reduced susceptibility to infections, except after initiation of iron therapy. The treatment of nutritional anaemia includes replacement of the deficient nutrients (and blood transfusion in severe cases), prevention of further nutrient losses and treatment of associated complications.

Topics: Adult; Africa; Anemia; Anemia, Hypochromic; Anemia, Megaloblastic; Child; Deficiency Diseases; Female; Folic Acid; Folic Acid Deficiency; Humans; Iron; Male; Pregnancy; Protein Deficiency; Tropical Climate; Vitamin B 12; Vitamin B 12 Deficiency

Since 1949, the World Health Organization, recognizing the public health importance of nutritional anemia, has sponsored efforts directed towards its understanding and control. During this period, often as a result of the work of the Organization, advances have been made in many areas. Basic understanding of iron, folate and vitamin B12 nutrition, and the various factors which may influence the availability and requirements of these factors, has greatly increased. Surveys in a number of countries have highlighted the widespread prevalence of nutritional anemia, particularly in developing countries. The major factor responsible is a deficiency of iron, whith folate deficiency also playing a role in some population groups, especially in preganant women. There is increasing evidence that anemia adversely affects the health of individuals and may have profound socioeconomic consequences. Control of nutritional anemia is possible by providing the deficient nutrient(s) either as therapeutic supplements or by fortification of commonly used foodstuffs. Some control programs are reviewed and suggestions for further action outlined. The Organization still has an important role to play in this field, encouraging the development of control programs and providing advice and technical assistance ot member countries.

Topics: Adolescent; Adult; Anemia, Hypochromic; Child; Child, Preschool; Female; Folic Acid; Folic Acid Deficiency; Food, Fortified; Health Planning; Humans; Infant; Iron; Male; Nutritional Requirements; Parasitic Diseases; Pregnancy; Pregnancy Complications; Vitamin B 12; Vitamin B 12 Deficiency; World Health Organization

Topics: Anemia; Anemia, Hemolytic; Anemia, Hemolytic, Congenital; Anemia, Hypochromic; Anemia, Macrocytic; Anemia, Megaloblastic; Anemia, Sideroblastic; Chronic Disease; Diagnosis, Differential; Humans; Malabsorption Syndromes; Thalassemia; Vitamin B 12

The role of the metals, iron and copper, and the vitamins E, folic acid, and B12 in the genesis of nutritional anemias in infancy have been reviewed. All are preventable. The precise requirements for each of these trace elements and vitamins in the small premature infant remain to be defined. The nonhematologic consequences of these nutritional deficiencies require further study. Anemia may prove to be the least important manifestation of the deficiency states.

Topics: Adolescent; Anemia; Anemia, Hemolytic; Anemia, Hypochromic; Child; Child, Preschool; Copper; Female; Folic Acid; Folic Acid Deficiency; Growth; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Infant, Premature; Iron; Nutritional Requirements; Pregnancy; Vitamin B 12; Vitamin B 12 Deficiency; Vitamin B Deficiency; Vitamin E; Vitamin E Deficiency

Topics: Adult; Anemia; Anemia, Hypochromic; Contraceptives, Oral; Deficiency Diseases; Female; Folic Acid; Folic Acid Deficiency; Hemoglobins; Humans; Iron; Iron Deficiencies; Lactation; Male; Menstruation; Middle Aged; Nutritional Requirements; Pregnancy; Pregnancy Complications; Sex Factors; United States; Vitamin B 12; Vitamin B 12 Deficiency

Asymptomatic small intestinal disease characterized by abnormalities of structure and function has been reported from many developing countries. Abnormalities of structure include changes in villus architecture and in appearance under both the light and the electron microscope. Changes in function include abnormalities in the absorption of xylose, fat, vitamin B(12), amino acids, and dipeptides and excessive faecal losses of nitrogen and energy. The etiology of the condition is unknown but appears to be closely related to exposure to the environment. The nutritional consequences of this condition have not been fully explored but for people living on marginally sufficient dietary intakes they may be extremely important.

Topics: Anemia, Hypochromic; Ascariasis; Developing Countries; Humans; Intestinal Absorption; Intestine, Small; Intestines; Lipid Metabolism; Malabsorption Syndromes; Protein Deficiency; Tropical Climate; Vitamin B 12; Vitamin B 12 Deficiency; Xylose

Topics: Adult; Anemia; Anemia, Hypochromic; Deficiency Diseases; Female; Folic Acid; Folic Acid Deficiency; Food, Fortified; Hemoglobins; Humans; International Cooperation; Iron; Male; Pregnancy; Pregnancy Complications; 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: Anemia, Hypochromic; Birth Weight; Clinical Trials as Topic; Dose-Response Relationship, Drug; Female; Folic Acid; Hematocrit; Hemoglobins; Humans; India; Infant; Iron; Pregnancy; Pregnancy Complications, Hematologic; Pregnancy Trimester, Second; Vitamin B 12

Topics: Anemia; Anemia, Hypochromic; Diet Therapy; Folic Acid; Humans; Iron; Nutrition Disorders; Riboflavin Deficiency; Vitamin B 12; Vitamin B 12 Deficiency

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, Hemolytic; Anemia, Hypochromic; Anemia, Megaloblastic; Arthritis, Juvenile; Arthritis, Rheumatoid; Blood Volume; Collagen Diseases; Dermatomyositis; Felty Syndrome; Folic Acid; Hemolysis; Humans; Hyperplasia; Iron; Lupus Erythematosus, Systemic; Myositis; Polyarteritis Nodosa; Polymyalgia Rheumatica; Scleroderma, Systemic; Vitamin B 12

Topics: Anemia; Anemia, Hypochromic; Anemia, Macrocytic; Anemia, Sickle Cell; Child; Child, Preschool; Feces; Female; Fever; Folic Acid; Hemoglobinopathies; Hookworm Infections; Humans; Infant; Leishmaniasis, Visceral; Malaria; Male; Pregnancy; Protozoan Infections; Schistosomiasis; Vitamin B 12

Topics: Adult; Aged; Anemia, Hypochromic; Blood Pressure; Body Weight; Dyspepsia; Female; Gastrectomy; Hemoglobins; Humans; Iron; Male; Middle Aged; Peptic Ulcer; Postoperative Complications; Time Factors; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Anemia, Hypochromic; Anemia, Macrocytic; Biological Transport; Diet; Female; Folic Acid; Folic Acid Deficiency; Food; Hematopoiesis; Humans; Intestinal Absorption; Iron; Male; Pregnancy; Protein Binding; 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, Hemolytic; Anemia, Hemolytic, Congenital Nonspherocytic; Anemia, Hypochromic; Anemia, Macrocytic; Blood Transfusion; Erythropoiesis; Glucocorticoids; Humans; Iron; Vitamin B 12

Topics: Anemia; Anemia, Hypochromic; Anemia, Macrocytic; Anemia, Sideroblastic; Arthritis, Rheumatoid; Bone Marrow; Cobalt; Erythrocytes; Female; Folic Acid; Folic Acid Deficiency; Gastric Acidity Determination; Hemoglobinometry; Humans; Intestinal Absorption; Iron; Liver Extracts; Male; Mononuclear Phagocyte System; Plasma Volume; Potassium; Salicylates; Sex Factors; Steroids; Vitamin B 12

Topics: Adult; Age Factors; Aged; Anemia, Hypochromic; Epilepsy; Female; Folic Acid; Humans; Male; Middle Aged; Psychotic Disorders; Schizophrenia; Vitamin B 12

Topics: Anemia, Hypochromic; Anemia, Macrocytic; Anemia, Pernicious; Chronic Disease; Hemoglobinometry; Hemolysis; Humans; Liver; Liver Cirrhosis; Liver Diseases; Vitamin B 12

Topics: Anemia, Aplastic; Anemia, Hemolytic; Anemia, Hemolytic, Congenital; Anemia, Hypochromic; Anemia, Pernicious; Anticoagulants; Chelating Agents; Erythroblastosis, Fetal; Exchange Transfusion, Whole Blood; Female; Fibrinolysis; Folic Acid Deficiency; Hematologic Diseases; Hemoglobinopathies; Hemophilia A; Hemophilia B; Humans; Infant, Newborn; Iron; Leukemia; Pregnancy; Splenectomy; Vitamin B 12; Vitamin B 12 Deficiency; Waldenstrom Macroglobulinemia

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

Topics: Adrenal Cortex Hormones; Anabolic Agents; Anemia; Anemia, Aplastic; Anemia, Hemolytic; Anemia, Hypochromic; Anemia, Pernicious; Humans; Hypersplenism; Iron; Iron-Dextran Complex; Liver Extracts; Steroids; Vitamin B 12; Vitamin B Complex

Topics: Anemia, Hypochromic; Child; Child, Preschool; Drug Administration Schedule; Folic Acid; Hemoglobins; Humans; Infant; Iron; Vitamin A; Vitamin B 12; Vitamin D

The effectiveness of orally administered iron was investigated using three different iron preparations in a randomized study with 3 patient groups, each consisting of 20 subjects with iron deficiency anaemia. Group A received a ferric(III)-dextrin complex, group B Fe(II)-sulfate, and group C Fe(II)-fumarate with vitamins. For all three preparations the increase in the number of erythrocytes as well as hemoglobin and hematocrit values ran absolutely parallel for a period of 12 weeks. A relevant difference between the trivalent ferric-dextrin complex and the two bivalent iron preparations could not be detected on evaluation of the parameters measured except for a moderate increase in the transaminase values in the patients group who received the Fe(II)-sulfate preparation. No differences were found among the preparations with respect to tolerance. The results are discussed with respect to a possible overloading of the iron transport system by highly absorptive Fe(II)-preparations.

Topics: Adult; Anemia, Hypochromic; Erythrocyte Count; Female; Ferric Compounds; Ferrous Compounds; Folic Acid; Hematocrit; Hemoglobins; Humans; Iron; L-Lactate Dehydrogenase; Male; Middle Aged; Vitamin B 12

Topics: Anemia, Hypochromic; Child, Preschool; Clinical Trials as Topic; Ferrous Compounds; Folic Acid; Hematinics; Humans; India; Infant; Rural Population; Urban Population; Vitamin B 12

1. A study was conducted in two centres in southern and northern India of the effects of the addition of ascorbic acid and protein supplements to iron, pteroyglutamic acid and cyanocobalamin, in the prophylaxis and treatment of anaemia of pregnancy. 2. A dose of 500 mg ascorbic acid/d had no beneficial effect. Women who received 15 g calcium caseinate/d showed a superior haematological response. The reasons for this are unknown, but are more likely attributable to an increased absorption of the supplemental iron than to the correction of a protein deficiency.

Topics: Anemia, Hypochromic; Ascorbic Acid; Caseins; Female; Folic Acid; Hematocrit; Hemoglobins; Humans; India; Iron; Pregnancy; Pregnancy Complications; Vitamin B 12

1. The relative efficacy of oral and parenteral iron administration in the prophylaxis and treatment of Fe-deficiency anaemia of pregnancy has been studied. 2. Intravenous administration of Fe by total dose infusion of Fe dextran was not superior to oral Fe 120 mg/d, 6 d/week for 10-12 weeks. 3. Intramuscular Fe dextran, 100 mg twice per week for 10-12 weeks, produced a significantly greater rise in mean haemoglobin concentration than oral Fe therapy. 4. The superiority of intramuscular Fe as compared with intravenous Fe is probably related to the different handling of the Fe dextran by the reticulo-endothelial system. 5. In spite of the better response to intramuscular Fe dextran, it is not recommended for public health practice because of the risks associated with its use and the much higher cost of the preparation and its delivery.

Topics: Administration, Oral; Anemia, Hypochromic; Female; Ferrous Compounds; Folic Acid; Hemoglobins; Humans; India; Injections, Intramuscular; Injections, Intravenous; Iron; Iron-Dextran Complex; Pregnancy; Pregnancy Complications; Vitamin B 12

128 women with mild anemias below 12 g% Hb received 100 mg iron or 100 mg iron, 0.44 mg folic acid and 0.66 mg vitamin B12 daily from the 20th to the 24th weeks of pregnancy until confinement. With pure iron therapy the maternal hemoglobin, erythrocyte, hematocrit and serum levels rose significantly, whereas in the placebo group (37 pregnant women) they fell markedly. Iron-folic acid-vitamin B12 administration led to no improvement in the hemoglobin regeneration or in the serum iron. After 60 days' treatment with the combined iron preparation, a rise in the serum and erythrocyte folate levels had already been achieved in the pregnancy women.

Topics: Anemia, Hypochromic; Drug Combinations; Erythrocytes; Female; Fetal Blood; Folic Acid; Hemoglobins; Humans; Intestinal Absorption; Iron; Placebos; Pregnancy; Pregnancy Complications, Hematologic; Pregnancy Trimester, Second; Pregnancy Trimester, Third; Prospective Studies; Vitamin B 12

A W.H.O. sponsored collaborative study of the effects of iron supplementation to pregnant women was carried out in Delhi (northern India) and Vellore (southern India). Supplementation was given under supervision from the 26th to the 36th or 38th week of pregnancy. A control group received only placebo; one group received vitamin B12 and folic acid alone; four groups received vitamin B12, folate and a daily iron supplement ranging from 30 to 240 mg of elemental iron as ferrous fumerate, and one further group received 120 mg of iron without B12 or folate. Groups receiving no iron showed a fall in mean stet concentration. Those receiving iron showed a rise in haemoglobin, the best results being in the groups receiving 120 and 240 mg of iron together with vitamin B12 and folate. Even in these groups however there was still a high prevalence of anaemia and iron deficiency at the end of the trial period. Iron alone did not produce as good results as iron plus vitamin B12 and folate. The supplementation had no detectable effect on the birth weight of the children, nor on the haemoglobin concentration of the infants at three months of age. The daily absorption of iron in the pregnant women, as judged from the increase in haemoglobin mass, was not as satisfactory as expected. Possible reasons for this are discussed. It is concluded that to provide these women with adequate iron a daily oral supplementation of 120 mg of elemental iron or more is needed. This can only be achieved by medicinal means. Before supplementation can be recommended on a public health scale, further information regarding the cost and expected benefits of such measures must be obtained.

Topics: Administration, Oral; Anemia, Hypochromic; Birth Weight; Clinical Trials as Topic; Female; Fetal Hemoglobin; Folic Acid; Hematocrit; Hemoglobins; Humans; India; Infant; Infant, Newborn; Iron; Placebos; Pregnancy; Pregnancy Complications, Hematologic; Pregnancy Trimester, Second; Pregnancy Trimester, Third; Vitamin B 12; World Health Organization

Topics: Anemia, Hypochromic; Birth Weight; Clinical Trials as Topic; Dose-Response Relationship, Drug; Female; Folic Acid; Hematocrit; Hemoglobins; Humans; India; Infant; Iron; Pregnancy; Pregnancy Complications, Hematologic; Pregnancy Trimester, Second; Vitamin B 12

Topics: Anemia; Anemia, Hypochromic; Blood Proteins; Clinical Trials as Topic; Deficiency Diseases; Drug Synergism; Female; Folic Acid; Hemoglobins; Humans; Iron; Pregnancy; Pregnancy Complications, Hematologic; Protein Binding; Transferrin; Vitamin B 12

Topics: Administration, Oral; Adolescent; Adult; Anemia, Hypochromic; Child; Colloids; Female; Folic Acid; Humans; Iron; Male; Middle Aged; Oxides; Sulfates; Vitamin B 12

We report a rare case of subacute combined degeneration of the spinal cord concomitant with gastric cancer. A 67-year-old man was admitted because of posterior column symptoms, pyramidal tract sign and peripheral neuropathy with severe hyperchromic anemia. He was treated with mecobalamin 1 mg IM, after which his anemia and neurological signs recovered. He was diagnosed as having subacute combined degeneration with pernicious anemia. Subsequent stomach biopsy revealed gastric cancer, and the patient underwent gastrectomy. It is a well known association that chronic atrophic gastritis is associated with gastric cancer or subacute combined degeneration. Our findings suggest that in this case subacute combined degeneration and gastric cancer are independent of each other; rather, both resulted from chronic atrophic gastritis.

Topics: Aged; Anemia, Hypochromic; Humans; Male; Nerve Degeneration; Peripheral Nervous System Diseases; Spinal Cord; Spinal Cord Diseases; Stomach Neoplasms; Vitamin B 12

Topics: Adult; Anemia, Hypochromic; Arthroplasty, Replacement, Hip; Chronic Disease; Colitis; Drug Therapy, Combination; Epoetin Alfa; Erythropoietin; Ferric Compounds; Folic Acid; Humans; Intestinal Polyps; Leucovorin; Malabsorption Syndromes; Male; Methotrexate; Osteoarthritis, Hip; Preoperative Care; Recombinant Proteins; Rectal Diseases; Remission Induction; Spondylitis, Ankylosing; Time Factors; Vitamin B 12; Vitamin B 12 Deficiency

We have previously demonstrated that vitamin B12 (cobalamin)-deficient central neuropathy in the rat is associated with local overexpression of neurotoxic tumour necrosis factor (TNF)-alpha combined with locally decreased synthesis of neurotrophic epidermal growth factor (EGF). The aims of this study were to investigate whether a similar imbalance also occurs in the serum of adult patients with clinically confirmed cobalamin deficiency and whether it can be corrected by vitamin B12 replacement therapy.. We studied 34 adult patients with severe cobalamin deficiency, 12 patients with pure iron deficiency anaemia and 34 control subjects. Haematological markers of cobalamin deficiency and serum TNF-alpha and EGF levels were measured using commercial kits. Thirteen cobalamin-deficient patients were re-evaluated after 3 and 6 months of parenteral vitamin B12 treatment.. TNF-alpha was significantly higher (p < 0.01) and EGF significantly lower (p < 0.01) in the patients with cobalamin deficiency, but both were unchanged in patients with pure iron deficiency anaemia. In cobalamin-deficient patients the serum TNF-alpha levels correlated significantly with plasma total homocysteine levels (r = 0.425; p < 0.02). In the treated patients TNF-alpha and EGF levels normalised concomitantly with clinical and haematological disease remission.. In humans, as in rats, cobalamin concentration appears to be correlated with the synthesis and release of TNF-alpha and EGF in a reciprocal manner, because cobalamin deficiency is accompanied by overproduction of TNF-alpha and underproduction of EGF.

Topics: Adult; Aged; Aged, 80 and over; Anemia, Hypochromic; Anemia, Megaloblastic; Animals; Bone Marrow; Epidermal Growth Factor; Female; Folic Acid; Follow-Up Studies; Gastritis, Atrophic; Homocysteine; Humans; Iron; Iron Deficiencies; Male; Middle Aged; Peripheral Nervous System Diseases; Rats; Species Specificity; Tumor Necrosis Factor-alpha; Vitamin B 12; Vitamin B 12 Deficiency

Serum erythropoietin (sEpo) concentration is primarily related to the rate of renal production and, under the stimulus of hypoxia, increases exponentially as hemoglobin (Hb) decreases. Additional factors, however, appear to influence sEpo, and in this work, we performed studies to evaluate the role of the red blood cell precursor mass. We first compared the relationship of sEpo with Hb in patients with low versus high erythroid activity. The first group included 27 patients with erythroid aplasia or hypoplasia having serum transferrin receptor (sTfR) levels < 3 mg/L (erythroid activity < 0.6 times normal), while the second one included 28 patients with beta-thalassemia intermedia having sTfR levels > 10 mg/L (erythroid activity > 2 times normal). There was no difference between the two groups with respect to Hb (8.3 +/- 1.6 v 8.0 +/- 1.3 g/dL, P > .05), but sEpo levels were notably higher in patients with low erythroid activity (1,601 +/- 1,542 v 235 +/- 143 mU/mL, P < . 001). In fact, multivariate analysis of variance (ANOVA) showed that, at any given Hb level, sEpo was higher in patients with low erythroid activity (P < .0001). Twenty patients undergoing allogeneic or autologous bone marrow transplantation (BMT) were then investigated. A marked increase in sEpo was seen in all cases at the time of marrow aplasia, disproportionately high when compared with the small decrease in Hb level. Sequential studies were also performed in five patients with iron deficiency anemia undergoing intravenous (IV) iron therapy. Within 24 to 72 hours after starting iron treatment, marked decreases in sEpo (up to one log magnitude) were found before any change in Hb level. Similar observations were made in patients with megaloblastic anemia and in a case of pure red blood cell aplasia. These findings point to an inverse relationship between red blood cell precursor mass and sEpo: at any given Hb level, the higher the number of red blood cell precursors, the lower the sEpo concentration. The most likely explanation for this is that sEpo levels are regulated not only by the rate of renal production, but also by the rate of utilization by erythroid cells.

Topics: Anemia; Anemia, Aplastic; Anemia, Hypochromic; Anemia, Megaloblastic; Antineoplastic Combined Chemotherapy Protocols; beta-Thalassemia; Bone Marrow Transplantation; Erythrocyte Indices; Erythroid Precursor Cells; Erythropoiesis; Erythropoietin; Feedback; Folic Acid; Hodgkin Disease; Humans; Iron; Kidney; Receptors, Transferrin; Transplantation Conditioning; Vitamin B 12

We introduced a terminal ileal transposition procedure (TITP) in ileal pouch-anal anastomosis, in which a 50 to 70 cm isolated ileal segment 20 to 40 cm from the ileocecal valve was interposed between the terminal ileum and the anus. Twelve patients underwent this procedure in two or three-staged operations. Mean stool frequency per 24 hours was 4.4 +/- 1.7, and stool consistency was formed and soft in all patients at the mean of 13 months after TITP. We observed neither surgical technique-related complications nor metabolic disorders, except for iron deficiency anemia, during and after the operations. The serum level of vitamin B12 significantly increased after the operation in eight patients (P < 0.05). TITP has advantages such as preventing the terminal ileum from metabolic dysfunction due to pouchitis, avoiding sacrifice of the terminal ileum in the two-staged operation, and obviating the need for reconstruction of ileostomy in the three-staged operation. It may also promote intestinal absorption and reduce late metabolic complications.

Topics: Adolescent; Adult; Aged; Anal Canal; Anastomosis, Surgical; Anemia, Hypochromic; Female; Humans; Ileum; Male; Middle Aged; Postoperative Complications; Proctocolectomy, Restorative; Vitamin B 12

Estimation of red cell ferritin (RCFer) may give a good indication of iron supply to the erythron and it may therefore be clinically useful for the detection of functional iron deficiency. In a cross-sectional study of hemodialysis patients on erythropoietin (EPO) therapy and regular oral iron we have compared the RCFer levels with conventional indicators of iron status. The patients studied, 19 female, 48 male, mean age 62 +/- 3.6 years (range 20-83 years) were characterized by the following mean parameters: aluminum 1.24 +/- 0.12 mumol/L, PTH 115.7 +/- 39 pg/mL, vitamin B12 626 +/- 71.2 ng/L, serum folate 18.8 +/- 2.2 micrograms/L, and hemoglobin 9.8 +/- 0.3 g/dL (range 7.3-12.4). The median serum ferritin (SF), RCFer, total iron binding capacity (TIBC), transferrin saturation (TS), and serum iron were 68 micrograms/L, 14.1 ag ferritin/red cell, 57 mumol/L, 20% and 11.5 mumol/L, respectively. Eleven patients had a reduced RCFer (< 7 ag ferritin/red cell), 5 had a SF of < 15 micrograms/L and 22 a TS of < 16%. The occurrence of functional iron deficiency was suggested by the presence of 10 subjects with reduced RCFer despite normal SF levels (15-240 micrograms/L). Four patients with reduced SF showed acceptable levels of RCFer, suggesting that some patients may maintain an adequate iron supply despite diminished iron stores. Despite oral iron therapy, a significant number of patients (63%) on regular hemodialysis remain relatively iron deficient with a serum ferritin of less than 100 micrograms/L. It has previously been proposed that oral iron provides adequate supplementation during increased demand caused by EPO stimulation. The present study has demonstrated overt iron deficiency in five subjects and suggests functional iron deficiency in a further seven (22% of total patients). We therefore conclude that oral iron therapy cannot maximize the response to EPO.

Topics: Administration, Oral; Adult; Aged; Aged, 80 and over; Aluminum; Anemia, Hypochromic; Biomarkers; Cross-Sectional Studies; Erythrocytes; Erythropoietin; Female; Ferritins; Folic Acid; Hemoglobins; Humans; Iron; Iron Deficiencies; Male; Middle Aged; Renal Dialysis; Vitamin B 12

The relationship between iron status and the restless legs syndrome (RLS) was examined in 18 elderly patients with RLS and in 18 matched control subjects. A rating scale with a maximum score of 10 was used to assess the severity of RLS symptoms. Serum ferritin levels were reduced in the RLS patients compared with control subjects (median 33 micrograms/l vs. 59 micrograms/l, p < 0.01, Wilcoxon signed rank test); serum iron, vitamin B12 and folate levels and haemoglobin levels did not differ between the two groups. Serum ferritin levels were inversely correlated with the severity of RLS symptoms (Spearman's rho -0.53, p < 0.05). Fifteen patients with RLS were treated with ferrous sulphate for 2 months. RLS severity score improved by a median value of 4 points in six patients with an initial ferritin < or = 18 micrograms/l, by 3 points in four patients with ferritin > 18 micrograms/l, < or = 45 micrograms/l and by 1 point in five patients with ferritin > 45 micrograms/l, < 100 micrograms/l. Iron deficiency, with or without anaemia, is an important contributor to the development of RLS in elderly patients, and iron supplements can produce a significant reduction in symptoms.

Topics: Aged; Aged, 80 and over; Anemia, Hypochromic; Female; Ferritins; Folic Acid; Hemoglobins; Humans; Iron; Male; Neurologic Examination; Restless Legs Syndrome; Vitamin B 12

Iron deficiency involvement in the results of long-term replacement therapy of renal anemia with recormon, a preparation of recombinant human erythropoietin, has been studied in chronic renal failure patients on programmed hemodialysis. The effect of recormon subcutaneous administration to 51 patients was found reduced in 9 patients; in 5 of them the decreased sensitivity to recormon was attributed to iron deficiency. During a year of treatment the percentage of iron-deficient patients rose from 9.1% to 45% as a result of intensive uptake of iron in the course of erythropoiesis. Iron preparation as a corrective treatment contributed to hematocrit increment reducing effective doses of erythropoietin. In addition to routine control of ferritin and iron it is recommended to trace the degree of transferrin saturation in the course of recombinant erythropoietin therapy.

Topics: Anemia, Hypochromic; Drug Evaluation; Erythropoietin; Ferritins; Folic Acid; Folic Acid Deficiency; Humans; Iron; Kidney Failure, Chronic; Recombinant Proteins; Renal Dialysis; Transferrin; Vitamin B 12; Vitamin B 12 Deficiency

Among 106 pregnant women with anaemia a typical state of iron deficiency could be shown at only 36.8%. 22.5% of the patients had a decreased vitamin B12 level without any characteristic symptoms of a megaloblastic anaemia. Predominantly the grade of the anaemia was small. The mean value of hemoglobin lied at 7.1 +/- 0.59 mmol/l. The severity of the anaemia didn't show any connection to the vitamin B12 level or parameters of the iron metabolism. With a combined therapy of iron, folic acid and vitamin B12 an increase of the Hb-level could be noticed at only 44.3% of the patients. The haematological findings, taken before the therapy, as well as the therapy results show that an important part of anaemias in pregnancy is caused by a complex genesis as a result of immunological reactions in pregnancy.

Topics: Adolescent; Adult; Anemia, Hypochromic; Anemia, Megaloblastic; Dose-Response Relationship, Drug; Drug Therapy, Combination; Female; Ferrous Compounds; Folic Acid; Folic Acid Deficiency; Hemoglobinometry; Humans; Infant, Newborn; Iron; Pregnancy; Pregnancy Complications, Hematologic; Quaternary Ammonium Compounds; Vitamin B 12; Vitamin B 12 Deficiency

In various anaemias the values of 8 acute phase factors were determined simultaneously before and at the end of treatment: seromucoid, sialic acid, acid alpha 1-glycoprotein, alpha 1-antitrypsin, haptoglobin, ceruloplasmin, transferrin and fibrinogen. In iron-deficiency anaemia without coexistent inflammatory changes in organs the levels of 4 proteins--seromucoid, alpha 1-antitrypsin, ceruloplasmin and transferrin, were consistently raised. In iron-deficiency anemia with concomitant infection 4 proteins also were increased, but in place of alpha 1-antitrypsin the haptoglobin level was raised. In megaloblastic anaemia the ceruloplasmin level was increased, and in haemolytic anaemia one factor--sialic acid--was decreased. At the end of treatment the concentrations of certain proteins were changed depending on their specific role in various forms of anaemia and on various additional factors. In iron-deficiency anaemia without coexistent infection the concentration of seromucoid was decreased, and in this anaemia with coexistent infection alpha 1-antitrypsin, haptoglobin, and fibrinogen levels were raised, in haemolytic anaemia only fibrinogen was increased, and megaloblastic anaemia was associated with raised seromucoid level. The therapeutic result was good in all these anaemias with the exception of iron-deficiency anaemia associated with infection in which it was less propitious.

Topics: Acute-Phase Proteins; Adolescent; Adult; Aged; Anemia; Anemia, Hemolytic, Autoimmune; Anemia, Hypochromic; Anemia, Megaloblastic; Anemia, Sideroblastic; Female; Glucocorticoids; Humans; Iron; Male; Middle Aged; Vitamin B 12

Topics: Anemia, Hypochromic; Anemia, Megaloblastic; Female; Gastrectomy; Humans; Iron; Male; Vitamin B 12

The haematological status, as well as the fractional absorptions of folic acid-and of vitamin B12 (FAFol and FAB12) were studied longitudinally in 20 coelic children aged 1.2-16.6 yr (mean 7.5 yr) during periods of gluten-free and gluten containing diets. The absorption methods were specially adapted to use in children, and age-related reference limits were established. Also, dietary intakes of iron, folate and B12 were registered. The haemoglobin concentrations did not show any significant differences in relation to shifts in diet. A few had mild anaemia while the haemoglobin concentrations in the other patients remained within normal range. The iron status, as judged from mean corpuscular volume (MCV), serum (S)-iron, S-transferrin and saturation %, appeared to be generally insufficient. However, the only significant change related to shifts in diet was an increase of S-iron during the first period of gluten-free diet. Dietary intakes of iron proved to be insufficient, regardless of the type of diet. Plasma (P)-B12 concentrations demonstrated a wide range of values above the lower normal limit, whereas the level in a single patient was within the "intermediate range" of B12 insufficiency (150-200 pmol/l). The folate status (erythrocyte-folate) showed significant variations related to dietary changes. However, few patients were folate depleted. FAFol and FAB12 demonstrated rapidly occurring, and significant decreases and increases in relation to gluten challenge and gluten-free diet, respectively. Bacterial overgrowth of the small intestinal tract was not found to be a plausible cause of the B12 malabsorption in the case of 5 patients observed.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Adolescent; Anemia, Hypochromic; Celiac Disease; Child; Child, Preschool; Diet; Female; Folic Acid; Glutens; Humans; Infant; Iron; Longitudinal Studies; Male; Vitamin B 12

Glycosylated haemoglobin (HbA1c) was measured in 10 patients with iron deficiency anaemia, 10 patients with vitamin B12 deficiency anaemia and 10 healthy controls. Initially there were no significant differences between the groups (P greater than 0.4), but after treatment with iron and vitamin B12 for 3 and 6 weeks, the glycosylated haemoglobin concentration decreased significantly (P less than 0.01). It was concluded that glycosylated haemoglobin is a sensitive marker of the changes in the erythrocyte population that are observed when predominantly immature erythrocytes are being produced.

Topics: Adult; Aged; Aged, 80 and over; Anemia, Hypochromic; Erythrocyte Indices; Glycated Hemoglobin; Humans; Iron; Middle Aged; Vitamin B 12; Vitamin B 12 Deficiency

The blood iron, vitamin B-12, and folate status of the 1985 birth cohort of Dutch infants aged 10.1-20.4 mo fed macrobiotic diets (n = 50) and matched omnivorous control infants (n = 57) was measured. Fe deficiency (combination of Hb less than 120 g/L, ferritin less than 12 micrograms/L, and FEP greater than 1.77 mumol/L) was observed in 15% of the macrobiotic group but not in the control group (p = 0.003). Plasma vitamin B-12 concentrations in the macrobiotic group were far below those of the control group (geometrical mean: 149 and 404 pmol/L, respectively, p less than 0.001). Plasma folate concentrations were higher in the macrobiotic group (31.6 +/- 11.7 nmol/L) than in the control group (21.1 +/- 8.8 nmol/L, p less than 0.001). In the macrobiotic group mean corpuscular volume, mean corpuscular hemoglobin mass, and mean corpuscular hemoglobin concentration were higher and hematocrit and red blood cells were lower (all p less than 0.05) than in the control group. It is advised to incorporate regular servings of animal foods into the macrobiotic diet to obtain an adequate amount of vitamin B-12.

Topics: Anemia, Hypochromic; Cohort Studies; Diet, Vegetarian; Female; Ferritins; Folic Acid; Humans; Infant; Infant Nutritional Physiological Phenomena; Infant, Newborn; Male; Netherlands; Nutritional Requirements; Risk; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Anemia, Hypochromic; Child, Preschool; Folic Acid Deficiency; Humans; Infant; Prospective Studies; Protein-Energy Malnutrition; Vitamin B 12

Cobalamin deficiency has well-known hematologic and neurologic effects, but little is known about its other effects. We therefore studied the effect of cobalamin on osteoblast-related proteins. We found that mean (+/- 1 SD) levels of skeletal alkaline phosphatase in the blood were lower in 12 cobalamin-deficient patients (3.89 +/- 2.19 units per liter) than in 5 nondeficient and 5 iron-deficient control subjects (7.55 +/- 3.99 units per liter). The degree of the megaloblastic anemia correlated with the reduction in skeletal alkaline phosphatase levels (r = 0.67, P less than 0.01). With cobalamin therapy, levels of skeletal alkaline phosphatase rose in 11 of the 12 cobalamin-deficient subjects but not in the controls. The cobalamin-deficient patients also had significantly lower osteocalcin levels than the control subjects (1.11 +/- 0.77 vs. 1.84 +/- 0.49 nmol per liter). During cobalamin therapy, these levels rose in the cobalamin-deficient patients but not in the controls. In contrast to the levels of osteoblast-related proteins, hepatic alkaline phosphatase levels were similar in the patients and controls and were usually unaffected by cobalamin therapy. In vitro studies of calvarial cells from chicken embryos showed that their alkaline phosphatase content was cobalamin-dependent, thus supporting our in vivo observations in humans. Our findings suggest that osteoblast activity depends on cobalamin and that bone metabolism is affected by cobalamin deficiency, but we do not yet know whether cobalamin deficiency produces clinically important bone disease.

Topics: Adult; Aged; Aged, 80 and over; Alkaline Phosphatase; Anemia, Hypochromic; Animals; Bone and Bones; Calcium-Binding Proteins; Cells, Cultured; Chick Embryo; Female; Humans; Male; Middle Aged; Osteoblasts; Osteocalcin; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Administration, Oral; Anemia, Hypochromic; Folic Acid; Hematopoiesis; Humans; Infusions, Parenteral; Iron; Vitamin B 12

A representative sample (n = 486) of a 75-year-old population was studied, and probands with defined laboratory aberrations were re-investigated. Anaemia was present in 6% of the men and 3% of the women; in 17/22 anaemic subjects a cause was found. The prevalence of plasma cobalamin concentrations less than 130 pmol/l was 6%, of iron deficiency approximately 6%. Divergences in white blood cell and platelet counts were rare. The observed haematological aberrations were almost always caused by disease. Reference intervals for haematological components were calculated in the total study group and two reference sample groups after exclusions based on anamnestic and/or laboratory screening criteria or anamnestic criteria and/or verified disease. The lower reference limits for B-Hb and P-B12 in a group obtained after exclusions based on anamnestic and screening data were considered to be minimum values for healthy subjects. The WHO criteria for anaemia were applicable.

Topics: Aged; Aging; Anemia; Anemia, Hypochromic; Female; Hematologic Diseases; Hemoglobins; Humans; Longitudinal Studies; Male; Sweden; Vitamin B 12

Serum ferritin, folate, cobalamin and hemoglobin concentrations were determined by radioimmunoassay, radioisotopic assay, radioassay and an automated hematology analyser respectively, and then analysed in 221 normal full-term pregnant women in order to evaluate the incidence and the prevalence of nutritional anemia in pregnancy. None of them had received any hematonic during their pregnancy. Their mean age was 27.68 years and the mean duration of pregnancy was 39.51 weeks. Twenty-three (10.41%) of these previously non-anemic pregnant women had clinical anemia after full-term pregnancy. Of the 23 women, 11 (47.83%) had iron-deficiency anemia, with serum ferritin less than 12 micrograms/l; another 11 women had some degree of iron depletion, with serum ferritin less than 20 micrograms/l. So in 22 of the 23 anemic women (95.65%) the cause of anemia may correlate to iron depletion. The remaining one had folate-deficiency anemia. No pure cobalamin deficiency anemia was found in this study. Among the 198 non-anemic normal full-term pregnant women, 92 (46.46%) had iron depletion (serum ferritin less than 20 micrograms/l), of whom 35 (17.68%) had severe iron deficiency, with serum ferritin less than 12 micrograms/l. Another 3 had folate deficiency and 3 had cobalamin deficiency. By including all the anemic and non-anemic pregnant women, 114 (51.58%) of them had some degree of iron depletion. In other words, pregnancy can produce a considerable degree of iron depletion in more than half of the previously non-anemic women.

Topics: Adult; Anemia; Anemia, Hypochromic; China; Female; Ferritins; Folic Acid; Folic Acid Deficiency; Humans; Pregnancy; Pregnancy Complications, Hematologic; Vitamin B 12; Vitamin B 12 Deficiency

We assessed iron status in patients with pernicious anemia. Iron deficiency coexisted as a presenting finding in 25 (20.7%) of 121 patients for whom data could be evaluated. Another 27 patients (22.3%) developed iron deficiency one month to 14 years later (median, two years). It was impossible to predict such a development in these 27 patients from any of their initial findings. The cause of the iron deficiency was identified in 17 of the 52 iron-deficient patients and suspected in another four. These findings show that patients with pernicious anemia are at high risk for iron deficiency, both at initial presentation and subsequently. Although the cause of the iron deficiency is often not identifiable, clinically important entities are detected often enough to warrant routine investigation for iron deficiency in such patients.

Topics: Adult; Aged; Anemia, Hypochromic; Anemia, Pernicious; Bone Marrow; Erythrocyte Indices; Female; Humans; Iron; Male; Middle Aged; Vitamin B 12

The prevalence of anaemia and deficiencies of iron, folate and vitamin B12 were investigated in 140 rural black preschool children aged 3-5 years living in five different villages in the Letaba area, near Tzaneen. Anaemia was highly prevalent, 39.2% of the children having haemoglobin levels below 11.1 g/dl. Approximately 10% were considered to be iron-deficient. On the basis of subnormal red cell folate values, 1 in 4 children was folate-deficient, suggesting the need for intervention at the community level such as enrichment of the staple foodstuff, maize meal, with folic acid.

Topics: Anemia, Hypochromic; Black or African American; Black People; Child, Preschool; Female; Ferritins; Folic Acid; Folic Acid Deficiency; Humans; Iron Deficiencies; Male; Rural Population; South Africa; Vitamin B 12; Vitamin B 12 Deficiency

The haematological variables, haematinic state, and placental function of more than 2000 pregnant women, heterozygous for either alpha- or beta-thalassaemia genes, were examined during pregnancy. Four features emerged. Firstly, it was possible by discriminant function analysis of haematological variables to distinguish in pregnant patients between the anaemia caused by thalassaemia trait and that caused by iron deficiency. Secondly, patients with thalassaemia become significantly more anaemic in pregnancy, beta more than alpha, but this was mainly due to plasma dilution. From the data percentile curves were drawn for each type of thalassaemia which predicted the patients' expected "normal" haemoglobin throughout gestation. Thirdly, patients with alpha-thalassaemia had the same incidence of iron deficiency as normal pregnant patients, whereas in those with beta-thalassaemia it was four times less common. The incidence of folic acid and vitamin B12 deficiency was the same in all groups. Finally, as assessed by serum oestriol concentration, there did not appear to be any abnormality of placental function or fetal development associated with maternal thalassaemia, and, also, there seemed to be no increase in maternal or fetal morbidity in pregnancy.

Topics: Adult; Anemia, Hypochromic; Diagnosis, Differential; Erythrocyte Count; Erythrocyte Indices; Estriol; Female; Ferritins; Folic Acid; Hemoglobin A2; Humans; Pregnancy; Pregnancy Complications, Hematologic; Thalassemia; Time Factors; Vitamin B 12

Topics: Anemia; Anemia, Hypochromic; Anemia, Sideroblastic; Female; Folic Acid; Humans; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Anemia, Hypochromic; Child, Preschool; Drug Therapy, Combination; Folic Acid; Folic Acid Deficiency; Humans; Infant; Iron; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Anemia, Hypochromic; Female; Folic Acid; Folic Acid Deficiency; Humans; Pregnancy; Pregnancy Complications, Hematologic; Vitamin B 12

Studies were carried out with the iron dextran preparation-100 and vitamin B12 at 100 gamma, applied to 80 pigs of 10 sows of the Camborough hybrid on two swine breeding complexes of different raising technologies. The pigs were divided into 4 groups of animals each. The Ist group was treated with dextrofer, the IInd--with dextrofer + vit. B12, the IIIrd--with vit. B12, and the IVth was left as control. The hemoglobin rate, erythrocyte, count, iron, and live-weight were followed up. It was found that the hemoglobin values at birth with the Ist group on the two complexes were within the range of 8.89 +/- 1.3 to 10.24 +/- 1.36 g/100 cm-3, while with the IInd group they were higher at weaning--11.8 +/- 0.48 g/100 cm3. The IIIrd and IVth group showed very low values at weaning--7.47 +/- 0.46 g/100 cm3 and 6.35 +/- 1.05 cm3. The twofold injection at a 7-day interval did not alter essentially the hemoglobin values. The pigs of the IInd group, injected twice, had much higher values of the erythrocyte count--7.58 +/- 0.09 T/L. The liveweight of the pigs of all four groups from the 7th day on ranged from 2.15 to 2.4 +/- 0.2 kg. Following a twofold injection with the pigs of the IInd group it rose to 6.1 +/- 0.14 kg. Similar proved the data concerning the iron in the blood plasma. Its values were highest with the pigs of the IInd group which were injected twice--38.86 +/- 1.7 mol/l.

Topics: Anemia, Hypochromic; Animals; Animals, Newborn; Drug Therapy, Combination; Erythrocyte Count; Hemoglobins; Iron; Iron-Dextran Complex; Swine; Swine Diseases; Time Factors; Vitamin B 12

Comparative investigations were carried out on the absorption, antianemic action, and growth effect with newborn pigs with FB-82 and dextrofer-100 (an iron dextran complex with 100 mg Fe3+ per cm3) injected i/m. The FB-82 is a combined preparation of 3500000 IU Tylosine tartrate, 0.008 g cyanocobalamin, 0.5 g pyridoxine hydrochloride, 0.1 g tartaric acid, and iron dextran up to 100 cm3 (= 100 mg Fe3+/cm3). Dextrofer-100 enriched with 50 mg Zn, 0.5 mg Co, 200 micrograms cyanocobalamin, and 100 mg pyridoxine hydrochloride for 100 cm3 under the compound name of fericin was also used to compare the anti-anemic effect of FB-82 and dextrofer-100. It was found that FB-82 applied to newborn pigs in a single dose of 2 cm3, i/m, was well absorbed; it developed high concentrations of tylosine in the plasma, and its sideremia and antianemic action were similar to those induced by an equivalent (with regard to iron) amount of dextrofer-100, whereas the result concerning the hematocrit value was better. Compared to dextrofer-100 the FB-82 preparation have better protection to pigs (lowered the mortality rate) and induced better development of the animals. Fericin did not differ essentially from FB-82 in terms of its effect on the red blood picture, however, the percent of protected pigs was lower.

Topics: Absorption; Anemia, Hypochromic; Animals; Animals, Newborn; Drug Combinations; Drug Evaluation; Growth; Iron; Iron-Dextran Complex; Leucomycins; Pyridoxine; Swine; Swine Diseases; Time Factors; Tylosin; Vitamin B 12

We studied 41 patients who had gastric bypass for obesity from 1974-1979. The procedure was well received by patients and most achieved adequate weight loss, but most subjects consumed inadequate diets and many developed iron and/or vitamin B12 deficiencies. Ten were anemic and 13 had been treated previously for postbypass anemia. Severely vitamin B12-deficient subjects did not respond to 50 micrograms oral vitamin B12 tablets, but those with milder deficiencies usually did. Schilling tests were usually abnormal and corrected when intrinsic factor was given. Many subjects developed manifestations compatible with osteoporosis due to inadequate calcium intake and absorption, and some also developed abnormal laboratory tests suggesting coexisting osteomalacia. Hematopoietic complications of gastric bypass can usually be prevented and are relatively easy to treat, but musculoskeletal complications may be more difficult to prevent and treat.

Topics: Adult; Anemia, Hypochromic; Body Weight; Diet; Female; Follow-Up Studies; Humans; Iron; Jejunum; Male; Middle Aged; Obesity; Osteoporosis; Postoperative Complications; Schilling Test; Stomach; Surveys and Questionnaires; Time Factors; Vitamin B 12; Vitamin B 12 Deficiency

In DNA synthesis deoxythymidine kinase (TK) catalyses the conversion of deoxythymidine to deoxythymidine monophosphate (dTMP) via the 'salvage pathway'. Serum deoxythymidine kinase (S-TK) was measured in this study in 75 patients with vitamin B12 deficiency by a new, very sensitive method, using 125I-deoxyuridine as substrate. Elevated S-TK levels were found in those patients who had developed haemolysis and anaemia and the more advanced the disease the higher the S-TK value. Thus there was a highly significant correlation between S-TK, haemoglobin level and lactic dehydrogenase activity. These findings are consistent with the theory that elevated levels of S-TK are due to release from unstable proliferating tissue.

Topics: Anemia, Hypochromic; Anemia, Megaloblastic; Hemoglobins; Humans; L-Lactate Dehydrogenase; Thymidine Kinase; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Adolescent; Adult; Anemia, Hypochromic; Anemia, Megaloblastic; Female; Folic Acid; Folic Acid Deficiency; Humans; Male; Middle Aged; Vitamin B 12; Vitamin B 12 Deficiency

The etiologic explanation of an anemia is important for the most effective therapy of that anemia. This may also define an underlying disease process. The etiology of the anemia can be achieved by appropriate use of the history, physical examination, and laboratory data. This information may be used to clarify the anemia, define a diagnosis, and direct appropriate therapy.

Topics: Anemia; Anemia, Hypochromic; Anemia, Macrocytic; Anemia, Sickle Cell; Blood Cell Count; Cytodiagnosis; Erythrocyte Indices; Erythrocyte Transfusion; Female; Ferrous Compounds; Hematologic Tests; Humans; Male; Physical Examination; Reticulocytes; Thalassemia; Vitamin B 12

Topics: Anemia, Hypochromic; Anemia, Pernicious; Blood Substitutes; Ferric Compounds; History, 20th Century; Humans; Thalassemia; Vitamin B 12

The supplementation of iron and folic acid were studied in 567 pregnant women with 18 and 26 weeks of gestation. Sixty mg and 180 mg of iron were given daily to pregnant women of group I and group II respectively while 180 mg of iron and 5 mg folic acid were given to group III. The Hb values increased significantly in group II and III after supplementation for 1 1/2 months, however if supplementation was extended for 3 months, highly significant increase in Hb levels were observed in all these groups. These findings indicated that in supplementation for a shorter period, i.e. 1 1/2 months at least 180 mg of iron was needed, and only 60 mg of iron was sufficient to increase Hb levels for a supplementation of 3 months. Vitamin B12 deficiency was not detected in pregnant women both before and after supplementation with iron and iron plus folate for 3 months. It was suggested therefore that perhaps it was not necessary to supplement vitamin B12 to Thai pregnant women. In this study 15% of pregnant women had low serum folate with normal red cell folate level, and a greater number of women with low serum folate concentrations were observed after supplementation with iron alone for 3 months. However, increased serum folate and red cell folate levels after supplementation with 5 mg folic acid indicated that some pregnant women needed folate supplementation in preventing folic acid deficiency during pregnancy.

Topics: Adolescent; Adult; Anemia, Hypochromic; Dose-Response Relationship, Drug; Female; Ferritins; Folic Acid; Humans; Iron; Pregnancy; Pregnancy Complications; Random Allocation; Vitamin B 12

Topics: Anemia, Hypochromic; Blood Cell Count; Bone Marrow; Child; Female; Humans; Iron; Vitamin B 12; Vitamin B 12 Deficiency

Typical features on the blood smear suggest the diagnosis in some types of anemia, such as the common microcytic anemias, megaloblastic anemias, and certain hemolytic anemias. Some laboratory tests used in anemia, particularly measurement of serum vitamin B12 and folate levels, may present problems in interpretation, which must be recognized if diagnostic errors are to be avoided. Normocytic anemias that are nonhemolytic, have no obvious cause, and are characterized by marked red cell changes on the blood smear should prompt careful investigation for malignancy or marrow fibrosis. Anemias are often multifactorial, and the diagnosis must be reevaluated after the apparent contributing causes have been treated. A number of "danger signs" in a patient with anemia point to the need for hematologic consultation.

Topics: Anemia; Anemia, Hemolytic; Anemia, Hypochromic; Anemia, Macrocytic; Bone Marrow Examination; Chronic Disease; Diagnosis, Differential; Folic Acid; Humans; Thalassemia; Vitamin B 12

Since physicians are routinely taught to review the peripheral blood smear results of all anemic patients, we analyzed the diagnostic value of the laboratory's blood smear reading and the incremental value of a physician's personal reading in anemic inpatients. Blood smear abnormalities, as reported by the laboratory and two hematologists, were poorly reproducible, with only five of the 11 types of abnormalities being more reproducible than could be expected by chance. The blood smear performed no better than RBC indices in detecting probable iron deficiency or low serum levels of folate or vitamin B12. In anemias not caused by deficiency states, the blood smear reading performed by the hospital laboratory provided unique information in 6% of the cases and helpful information in another 25%, but the additional reading performed by a hematologist never provided unique information and provided incremental helpful information in only 4% of the cases. The peripheral blood smears of all anemic inpatients should be read by the hospital laboratory, but in our hospital, a routine additional personal reading by a physician had limited incremental value and could be reserved for selected cases.

Topics: Anemia; Anemia, Hypochromic; Blood Cell Count; Clinical Laboratory Techniques; Erythrocyte Indices; Erythrocytes; Erythrocytes, Abnormal; Evaluation Studies as Topic; Female; Folic Acid; Hematocrit; Hematologic Tests; Humans; Male; Probability; Vitamin B 12

Topics: Aged; Aging; Alcoholism; Anemia; Anemia, Aplastic; Anemia, Hemolytic; Anemia, Hypochromic; Anemia, Macrocytic; Anemia, Pernicious; Animals; Blood Cell Count; Drug-Related Side Effects and Adverse Reactions; Female; Ferrous Compounds; Folic Acid; Folic Acid Deficiency; Gastrointestinal Hemorrhage; Humans; Male; Mice; Reference Values; 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

Owing to the higher serum cobalamin results that are obtained by R-binder radioisotopic dilution assay compared to microbiological assays (E. gracilis and L. leichmannii) it was suggested that serum contained a cobamide(s) that could not be detected by the more specific microbiological assays and that a much less specific test organism, which responds to most naturally occurring cobamides, such as the cobamide-dependent E. coli mutant, might respond to these cobamide(s) in serum. In an attempt to investigate this possibility an improved and simplified E. coli assay for the measurement of cobamide in serum was developed. The method is described, and the results obtained in normal subjects, in patients with megaloblastic anemia, and in anaemic pregnant women not suffering from megaloblastic anaemia are reported and compared with E. gracilis assay results.

Topics: Anemia, Hypochromic; Anemia, Megaloblastic; Anemia, Pernicious; Biological Assay; Cobamides; Escherichia coli; Euglena gracilis; Female; Humans; Pregnancy; Pregnancy Complications, Hematologic; Vitamin B 12

Topics: Anemia, Hypochromic; Female; Folic Acid; Humans; Male; Vitamin B 12

In 345 apparently healthy Papua New Guinea male subjects, predominantly highlanders, 89% of whom were infected with hookworm (Necator americanus), there was a statistically significant inverse correlation of hookworm egg count with haemoglobin and serum ferritin level, but no significant correlation with serum albumin, folate or B12 values. A sub-group of 128 was chosen for a six-month study on the effect of treatment with the anthelmintic mebendazole and/or parenteral iron on haemoglobin and serum ferritin levels. Mebendazole-treated subjects remained worm-free and the hookworm egg counts of the controls decreased during the study period. Parenteral iron treatment had the expected effect of raising haemoglobin to a normal level. There was a statistically significant improvement in haemoglobin level in all treated groups but not in the control. Serum ferritin levels decreased significantly in all groups, but more in the control than in the treated groups, although treatment groups were not significantly different. Although probable inadequate uptake of iron by the subjects and blood donation by some subjects was apparently more detrimental to iron status than hookworm infection, the results of this study support the view that hookworm infection in this country contributes to lowered haemoglobin levels and iron status.

Topics: Anemia, Hypochromic; Benzimidazoles; Drug Therapy, Combination; Ethnicity; Female; Ferritins; Folic Acid; Gluconates; Hemoglobins; Humans; Iron; Male; Mebendazole; Necatoriasis; Organometallic Compounds; Serum Albumin; Sorbitol; Vitamin B 12

Erythropoietin (ESF) titers were determined in sera from patients with different types of anemia using the fetal mouse liver cell bioassay. An inverse relationship was found between hemoglobin concentration and ESF titer. However, ESF titers differed markedly between patients at comparable degrees of anemia. Several groups of patients were distinguished on the basis of the activity of their erythroid bone marrow. In each of these groups, a significant negative correlation was found between the hemoglobin concentration and the logarithm of the ESF titer. ESF titers in patients with pure red cell aplasia were fourfold higher than those in patients with iron-deficiency anemia and tenfold higher than those in patients with megaloblastic anemia and homozygous sickle cell anemia at comparable hemoglobin concentrations. Following the initiation of specific therapy in patients with pernicious anemia and patients wit iron-deficiency anemia, serum ESF titers were found to decrease prior to any substantial rise in hemoglobin concentrations. In the patients with pernicious anemia, the lowest ESF levels were found 1 day after administration of vitamin B12, whereas in the patients with iron-deficiency anemia, the lowest ESF levels were reached in the second week of oral iron therapy. ON the basis of these data it was concluded that serum ESF titers in anemic patients are not only inversely related to the hemoglobin concentration but also to the activity of the erythroid bone marrow.

Topics: Anemia; Anemia, Hypochromic; Anemia, Pernicious; Animals; Bone Marrow Cells; Erythrocyte Count; Erythropoietin; Female; Hemoglobins; Humans; Iron; Mice; Mice, Inbred Strains; Pregnancy; Reticulocytes; Vitamin B 12

Experimental deficiencies of cyanocobalamin and folacin separately and in combination were induced in an air-breathing teleost fish Channa punctatus with the help of a complete vitamin test diet. Cyanocobalamin deficiency produced normocytic hypochromic anaemia while the folacin deficiency as well as the combined deficiency of both vitamins produced macrocytic hypochromic anaemia. Leucocytosis was observed in the individual and combined deficiencies of these vitamins with significant increase in thrombocytes and decrease in neutrophil population. The relative population of different developing stages in erythropoiesis showed significant change. Thus small lymphoid haemoblast decreased in number while young and mature reticulocyte populations increased. Recovery to normal condition could be obtained by restoring deficient groups of fishes to complete vitamin test diet fortified with an initial i.m. administration of 0.01 mg/g and 0.02 mg/g body wt. of cyanocobalamin and folacin respectively. A comparison of deficiency effects on C. punctatus with Labeo rohita shows that the former, a carnivorous species with higher Hb content in peripheral blood is more susceptible to deficiency than the latter, a herbivorous species of fish with lower Hb values.

Topics: Anemia, Hypochromic; Animals; Behavior; Diet; Erythropoiesis; Fishes; Folic Acid Deficiency; Hematopoiesis; Hemoglobins; Leukocyte Count; Mortality; Vitamin B 12; Vitamin B 12 Deficiency

In addition to the usual parameters for haematologic an rheumatologic diseases folic acid, vitamin B12, and ferritin were investigated by radioisotope studies. In some groups folic acid was lower compared to controls, and it is possible that the disease causes the deficiency of folic acid absorption and distribution. Vitamin B12 was only slightly decreased, thus, the values may be assumed to be close to normals. Transferrin ankylosing spondylitis is similar to that of controls, however, transferrin increases in rheumatoid arthritis and in mixed groups containing patients various diseases. Finally, the deficiency of folic acid absorption can be assumed to be caused by the symptoms of the disease, whereas in the case of inflammatory diseases and in mixed group transferrin increased.

Topics: Adult; Aged; Anemia, Hypochromic; Arthritis, Rheumatoid; Female; Ferritins; Folic Acid; Hematologic Tests; Humans; Male; Middle Aged; Radioisotopes; Spondylitis, Ankylosing; Vitamin B 12

Topics: Adult; Aftercare; Aged; Anemia, Hypochromic; Diarrhea; Disseminated Intravascular Coagulation; Embolism; Enterocolitis, Pseudomembranous; Female; Gastric Juice; Humans; Intestinal Absorption; Intestine, Small; Iron; Male; Mesenteric Arteries; Mesentery; Middle Aged; Mitral Valve Insufficiency; Sarcoma; Stomach Ulcer; Vitamin B 12

Topics: Adult; Anemia, Hypochromic; Drug Combinations; Erythrocyte Volume; Female; Ferrous Compounds; Folic Acid; Hemoglobins; Humans; Iron; Pregnancy; Pregnancy Complications, Hematologic; Vitamin B 12

Four patients on regular hemodialysis therapy with a persistent anemia and reduced serum vitamin B12 levels are discribed. In each case a significant improvement occurred with B12 therapy and it is suggested that the vitamin B12 content of a 70 g protein/day diet may not be adequate to maintain stores of the vitamin.

Topics: Adult; Anemia, Hypochromic; Female; Humans; Kidney Failure, Chronic; Male; Middle Aged; Renal Dialysis; Vitamin B 12

To better define the course of Crohn's disease, certain clinical, laboratory, and radiological features were studied prospectively in a representative group of 25 patients at intervals of up to 77 months. Eleven variables of potential use in assessing the course were analyzed for clinician preference, and the statistical relationship of one variable, the Crohn's disease activity index, to the other 10 was determined. Modest improvement was documented in three clinical variables, as well as in anemia, serum albumin, intestinal protein loss, and radiological extent of disease. Variables most frequently ranked high as reflections of the course of Crohn's disease were hematocrit and extent of disease, followed by body weight, stools per day, B12 absorption, serum albumin, and intestinal protein loss. The highest intervariable correlation was between improvement in protein loss and decrease in radiological extent (r = 0.75).

Topics: Adolescent; Adult; Anemia, Hypochromic; Body Weight; Child; Colon; Crohn Disease; Defecation; Female; Hematocrit; Humans; Intestine, Small; Iron; Male; Middle Aged; Prospective Studies; Proteins; Radiography; Serum Albumin; Vitamin B 12

The effect of combined iron-vitamin therapy and iron therapy only was studied in 14 respectively 14 children with hypochromic anemia. Pyridoxalphosphate in serum, activity of red cell glutamic oxaloacetic transaminase and excretion of 4-pyridoxic acid were measured as indices of vitamin B6 nutriture before therapy was started, four and seven days under therapy once more. Erythrocytes, reticulocytes, concentration of hemoglobin were simultaneously counted, whereas serum iron and transferrin have been measured before and after therapy. A group of 22 hematologically healthy children was studied as controls. After iron therapy a decrease of vitamin B6 body pool came off as a consequence of increased requirement of pyridoxalphosphate for heme synthesis. Additional dosage of vitamins compensated the biochemical B6 deficit and had an accelerating effect on heme synthesis.

Topics: Anemia, Hypochromic; Child, Preschool; Drug Combinations; Female; Folic Acid; Humans; Infant; Iron; Male; Pyridoxine; Riboflavin; Vitamin B 12; Vitamins

The probabilities of low transferrin saturation, folic acid, or vitamin B12 levels in association with various erythrocyte indices was determined from the prevalences of these abnormalities and the distributions of the indices among 206 hospitalized and 1,000 ambulatory anemic patients. At mean corpuscular hemoglobin (MCH) greater than 30 pg, the probability of low transferrin saturation was 0.04 for hospitalized patients and 0.14 for ambulatory anemic patients. For MCH less than 27 pg, the corresponding probabilities were 0.52 and 0.67. The probabilities of low vitamin B12 or folic acid levels among hospitalized anemic patients were 0.0011 for mean corpuscular volume (MCV) less than 95 cu micron and 0.18 for MCV greater than or equal to 95 cu micron, indicating that measurements of these vitamins are of very limited value in most cases of anemia. These findings indicate that in some patients, the erythrocyte indices are sufficiently predictive for or against deficiency states to facilitate decisions regarding further diagnostic tests, as opposed to the increasing tendency to order such tests regardless of the indices.

Topics: Anemia, Hypochromic; Erythrocytes; Evaluation Studies as Topic; Folic Acid; Folic Acid Deficiency; Hemoglobins; Humans; Methods; Transferrin; Vitamin B 12; Vitamin B 12 Deficiency

As part of a study of anemia associated with oral contraceptive use, serum vitamin B12 levels, unsaturated B12-binding capacity, and B12 binder fractionation were examined in 67 consecutive mildly anemic (hemoglobin levels below 13 gm%) women using oral contraceptives and 59 such women using other means of birth control. Results were correlated with hematologic parameters such as complete blood counts and evaluation of iron status. Hemoglobin levels were significantly lower (p 0.01) in the non-oral-contraceptive group, while serum iron levels were significantly higher (p 0.05) in the oral contraceptive group and fewer oral contraceptive users demonstrated iron-deficiency anemia. While no B12-deficient subjects were found, serum B12 levels were significantly lower among oral contraceptive users (p 0.05), but differences were more striking between iron-deficient and non-iron deficient subjects, regardless of oral contraceptive status (p 0.02). The role of iron status needs further clarification as the finding of higher serum B12 levels in iron-deficient subjects contrasts with previous reports of lower B12 levels in cases of disease-related iron deficiency. Moreover, the relationship between iron status and serum B12 level was significant only in the oral contraceptive group. Among pill users, iron deficiency was most frequent in those taking sequential rather than combination preparations (67 vs. 39%). Among non-oral-contraceptive subjects, iron deficiency incidence was 96% in IUD users. Serum unsaturated B12 binding capacity was unaffected by pill use, but pill users showed significantly higher transcobalamin I levels, correlating best with white blood cell counts. The assumption that this elevation reflects pill effect on protein synthesis is premature, even though a general increase in alpha 1-globulin has been reported in pill users. Transcobalamin II and 3rd binder levels were not affected and did not correlate with white blood counts. The correlation between UBBC levels and white blood cell counts was significant in both oral contraceptive and non-oral-contraceptive groups. In contrast to previous findings, UBBC could not correlated with any iron parameter.

Topics: Anemia, Hypochromic; Blood Proteins; Carrier Proteins; Contraceptives, Oral; Female; Humans; Leukocyte Count; Transcobalamins; Vitamin B 12

Vitamin B12 and vitamin B12 binding proteins were determined in 20 patients with iron deficiency anaemia who showed low haemoglobin, haematocrit, serum iron levels and hypochromic microcytic red blood cells. The serum vitamin B12 levels in these patients were significantly lower than that of the normal subjects. Nine of 20 patients had serum vitamin B12 less than 350 pg/ml. There was a significant increase in serum UBBC and TBBC levels in patient group and 9 of 20 patients had higher UBBC values than those of the normal subjects. The absolute values of TCI and TCII increased significantly while TCIII was within the normal limit even though the percentage of UBBC were not different from that of the normal subjects.

Topics: Anemia, Hypochromic; Blood Proteins; Child; Female; Humans; Male; Transcobalamins; Vitamin B 12

Iron absorption has been studied in patients with dermatitis herpetiformis (DH). Four patients out of 20 had iron deficiency, defined as absence of or only traces of haemosiderin in bone marrow smears. These four had adequate absorption of ferrous iron. The iron deficiency in at least 3 of them was ascribed to increased iron loss. The results indicate that, although having a mild to moderate malabsorption syndrome, DH patients can be expected to exhibit adequate absorption of orally administered iron. Explanations of a negative iron balance other than defective absorption should therefore be sought.

Topics: Adolescent; Adult; Aged; Anemia, Hypochromic; Dermatitis Herpetiformis; Female; Folic Acid; Gastric Juice; Haptoglobins; Hemoglobins; Hemosiderin; Humans; Intestinal Absorption; Iron; Male; Middle Aged; Vitamin B 12

Topics: Adolescent; Adult; Aged; Anemia, Hypochromic; Binding Sites; Blood Sedimentation; Diagnosis, Differential; Female; Folic Acid; Folic Acid Deficiency; Humans; Iron; Iron Deficiencies; Male; Middle Aged; Mouth Diseases; Prospective Studies; Recurrence; Stomatitis, Aphthous; Ulcer; Vitamin B 12; Vitamin B 12 Deficiency

Of 125 pregnant women, of whom 81 were treated and 44 not treated, 14 (12,5%) were found to be suffering from anemia, with a hemoglobin count to be diminished. In 31 cases iron deficiency was established and in 8 women vitamin B12 in serum was reduced. Iron and vitamin deficiencies were found more frequently in the non-treated group than in the treated group.

Topics: Adolescent; Adult; Anemia, Hypochromic; Female; Folic Acid; Folic Acid Deficiency; Hemoglobins; Humans; Iron; Pregnancy; Pregnancy Complications, Hematologic; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Anemia; Anemia, Hypochromic; Anemia, Macrocytic; Anemia, Pernicious; Ascorbic Acid; Bone Marrow Diseases; Female; Humans; Iron; Male; Pyridoxine; Vitamin B 12

In 26 patients with severe iron deficiency and microcytic anemia (MCV less than 70 fl), serial red cell size distribution histograms (erythrograms) were taken before and during iron therapy. Initially all patients had a single population of red cells, all microcytes. With the first reticulocytosis after iron therapy, a new population of cells appeared, larger in volume than the original. In 23 of 26 patients the new population of cells was of normal size (82-96 fl). In 3 of 26, the new population was macrocytic (MCV greater than 98 fl). Of these 3, 1 had folate deficiency; after folate was given, normocytes were produced. The other 2, both taking phenytoin and 1 a heavy alcohol using, had persistent macrocytosis despite folate administration. Erythrograms allowed quantitative, rapid evaluation of erythropoietic response to iron repletion. Abnormal macrocytic responses could be identified and seemed to occur with some frequency.

Topics: Anemia, Hypochromic; Cell Count; Erythroblasts; Erythrocytes; Erythropoiesis; Folic Acid; Humans; Iron; Vitamin B 12

The anemia observed in patients with partial gastric resection results from a complex interrelationship of deficiencies of these three important hematemics-iron, vitamin B12, and folic acid. Reliance upon morphological evidence of anemia in the peripheral blood smear may be difficult and confusing since deficiency of one hematemic may mask the coexisting deficiency of another. It is common for deficiencies of more than one hematemic to occur in these patients. A number of studies have demonstrated the masking effect of iron deficiency on concurrent vitamin B12 or folic acid deficiency. In addition, the morphologic hallmarks of iron deficiency may be modified by the presence of deficiencies of either vitamin B12 or folate or both. Full hematologic recovery may not occur until more than one hematemic is given to the patient. It is our policy at the University of Florida to rely on serum levels of these three hematemics, especially vitamin B12 and iron, to detect the cause of the anemia in a patient with partial gastric resection. Less reliance is placed upon the appearance of the peripheral smear because of the masking effect described above. If either the serum iron level or vitamin B12 level is decreased, we treat the patient with a preparation such as ferrous sulfate (300 mg. orally three times a day) and vitamin B12 (100 mug. intramuscularly once a month). We are less concerned with folic acid deficiency because of its relatively infrequent occurrence in this setting and because a good diet will usually suffice as adequate therapy for the folic acid deficiency when present. In patients who have had partial gastric resection but who are not anemic, we assess vitamin B12 absorption by the conventional vitamin B12 urinary excretion test (Schilling test) on a yearly basis since deficiency of this hematemic may lead to serious hematologic and neurologic sequelae. If the patient manifests decreased vitamin B12 absorption uncorrected by the administration of pancreatic extract or antibiotics, this patient is also treated with 100 mug. of vitamin B12 intramuscularly on a monthly basis. We have not evaluated the absorption of food B12 as suggested by Doscherholmen. Perhaps more attention should be paid to this aspect of vitamin B12 absorption in these patients. Indeed, because of the serious complications of vitamin B12 deficiency and the observations that deficiencies of this vitamin may occur even when the absorption of crystalline vitamin B12 is normal in the

Topics: Anemia, Hypochromic; Ferrous Compounds; Folic Acid Deficiency; Humans; Postgastrectomy Syndromes; Vitamin B 12; Vitamin B 12 Deficiency

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

Topics: Anemia, Hypochromic; Child; Female; Folic Acid; Humans; Vitamin B 12

Topics: Adult; Anemia, Hypochromic; Child; Cholelithiasis; Coronary Disease; Diabetes Mellitus; Diet Therapy; Diet, Diabetic; Diet, Reducing; Female; Humans; Hypertension; Male; Middle Aged; Obesity; Osteoporosis; Peptic Ulcer; Pregnancy; Ureteral Calculi; Urinary Bladder Calculi; Vitamin B 12; Vitamin B 6 Deficiency

Topics: Adult; Aged; Anemia, Hypochromic; Duodenum; Female; Folic Acid; Follow-Up Studies; Gastrectomy; Gastric Juice; Gastroenterostomy; Hemoglobins; Hemosiderin; Humans; Iron; Male; Menstruation; Middle Aged; Postgastrectomy Syndromes; Pyloric Antrum; Vagotomy; Vitamin B 12

The occurrence of anemia in a group of aged persons residing in a home for the aged and in a chronic disease hospital was reviewed with regard to etiology, choice of treatment, and therapeutic response. Of the 484 patients, 151 (31 per cent) had anemia or were receiving antianemia therapy. Iron-deficiency anemia was the most common type, and iron was the most common form of treatment. Seventy-eight patients were given antianemia therapy in 97 courses, and a good therapeutic result was achieved in about one-fourth of the courses. The most frequent error in iron therapy was its use in the anemia associated with chronic disorders. Often there was a combination deficiency of iron, vitamin B12 and folic acid. The response to iron in the elderly can be very slow, so therapy should not be discontinued too soon. Anemia may directly contribute to other serious pathologic conditions, especially in aged persons with impaired circulation. In some cases the physiologic concentration of hemoglobin may be higher than the accepted "normal" value. The course of the anemia in relation to the general state of the patient is more significant than any laboratory data in choosing antianemia therapy. Practical laboratory screening procedures for elderly anemic patients are discussed.

Topics: Aged; Anemia; Anemia, Hypochromic; Anemia, Macrocytic; Anemia, Pernicious; Chronic Disease; Female; Folic Acid; Folic Acid Deficiency; Hemoglobins; Humans; Iron; Male; Vitamin B 12

Topics: Anemia, Hypochromic; Celiac Disease; Crohn Disease; Diarrhea; Folic Acid; Humans; Ileum; Intestinal Absorption; Iron; Physician-Patient Relations; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Anemia, Hypochromic; Folic Acid; Hookworm Infections; Humans; Intestinal Absorption; Iron; Vitamin B 12

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: Altitude; Anemia, Aplastic; Anemia, Hemolytic; Anemia, Hypochromic; Erythropoiesis; Folic Acid; Humans; Polycythemia; Vitamin B 12

Topics: Anemia, Hypochromic; Avitaminosis; Folic Acid; Humans; Iron; Stomatitis, Aphthous; Vitamin B 12

Topics: Adolescent; Adult; Age Factors; Aged; Anemia; Anemia, Hypochromic; Australia; Child; Female; Folic Acid; Hemoglobins; Humans; Male; Middle Aged; Native Hawaiian or Other Pacific Islander; Pyridoxal; Sex Factors; Vitamin B 12

Topics: Adolescent; Anemia, Hypochromic; Binding Sites; Blood Bactericidal Activity; Blood Proteins; Child; Child, Preschool; Culture Techniques; Escherichia coli; Folic Acid; Hematocrit; Hemoglobins; Humans; Immunity, Cellular; Iron; Leukocytes; Lymphocyte Activation; Phagocytosis; Vitamin B 12

Topics: Agricultural Workers' Diseases; Anemia; Anemia, Hypochromic; Anemia, Megaloblastic; Diet; Folic Acid; Hookworm Infections; Iron; Sanitation; Socioeconomic Factors; Sri Lanka; Vitamin B 12

Topics: Adolescent; Adult; Anemia; Anemia, Hypochromic; Blood Proteins; Deficiency Diseases; Erythrocytes; Female; Folic Acid; Glucosephosphate Dehydrogenase; Glucosephosphate Dehydrogenase Deficiency; Hematocrit; Hemoglobins; Humans; Intestinal Diseases, Parasitic; Iron; Iron Deficiencies; Lactation; Malaria; Male; Middle Aged; New Guinea; Pregnancy; Protein Binding; Sex Factors; Splenomegaly; Thalassemia; Vitamin B 12

Topics: Anemia, Hypochromic; China; Ethnicity; Female; Folic Acid; Folic Acid Deficiency; Humans; India; Infant, Newborn; Iron; Malaysia; Pregnancy; Pregnancy Complications, Hematologic; Umbilical Cord; Vitamin B 12

Topics: Anemia; Anemia, Aplastic; Anemia, Hemolytic; Anemia, Hypochromic; Anemia, Megaloblastic; Anemia, Sideroblastic; Blood Transfusion; Diet Therapy; Female; Folic Acid; Humans; Iron; Kidney Diseases; Male; Postgastrectomy Syndromes; Pregnancy; Pregnancy Complications, Hematologic; Vitamin B 12

Topics: Adult; Anemia, Hypochromic; Female; Humans; Iron; Neutrophils; Vitamin B 12

Topics: Anemia, Hypochromic; Azathioprine; Blood Cell Count; Bone Marrow; Bone Marrow Cells; Bone Marrow Examination; Cadaver; Deoxyuridine; DNA; Erythrocytes; Erythrocytes, Abnormal; Female; Folic Acid; Hematocrit; Humans; Kidney Function Tests; Kidney Transplantation; Liver Function Tests; Male; Time Factors; Transplantation, Homologous; Tritium; Vitamin B 12

Topics: Adult; Aged; Alkaline Phosphatase; Anemia, Hypochromic; Binding Sites; Calcium; Diarrhea; Dumping Syndrome; Female; Folic Acid; Follow-Up Studies; Gastrectomy; Hemoglobins; Humans; Iron; Male; Methods; Middle Aged; Phosphorus; Postoperative Complications; Serum Albumin; Serum Globulins; Stomach Ulcer; Vitamin B 12; Vomiting

Topics: Anemia; Anemia, Hypochromic; Bilirubin; Electrophoresis; Folic Acid; Haptoglobins; Hemoglobins; Humans; Iron; L-Lactate Dehydrogenase; Transferrin; Vitamin B 12

Topics: Age Factors; Aged; Anemia, Hypochromic; Avitaminosis; Diet Therapy; Dietary Proteins; Folic Acid; Humans; Iron; Nutritional Requirements; Vitamin B 12; Vitamins

Topics: Anemia, Hypochromic; Ascariasis; Erythrocytes; Folic Acid; Hematocrit; Hemoglobinometry; Hookworm Infections; Humans; Infant Nutrition Disorders; Iron; Nutrition Disorders; Philippines; Protein Binding; Transferrin; Trichuriasis; Vitamin B 12

Topics: Adolescent; Adult; Anemia, Hypochromic; Bone Marrow Examination; Child; Electroencephalography; Electromyography; Evoked Potentials; Female; Folic Acid; Hemoglobinometry; Humans; Male; Middle Aged; Muscular Diseases; Nerve Degeneration; Neural Conduction; Neurologic Examination; Neurologic Manifestations; Night Blindness; Peripheral Nerves; Peripheral Nervous System Diseases; Potassium; Reflex, Monosynaptic; Serum Albumin; Sprue, Tropical; Vitamin B 12

Topics: Aged; Aging; Anemia, Hypochromic; Blood Glucose; Blood Sedimentation; Calcium; Cholesterol; Clinical Laboratory Techniques; Creatinine; Diabetes Mellitus; Female; Folic Acid; Geriatrics; Hemoglobinometry; Humans; Iodine; Iron; Leukocyte Count; Male; Osteomalacia; Phosphoric Monoester Hydrolases; Protein Binding; Thyroid Diseases; Urea; Uric Acid; Vitamin B 12

Topics: Ambulatory Care; Anemia, Hypochromic; Child; Child, Preschool; Dysentery, Bacillary; Hospitals, Special; Humans; Infant; Iron; Vitamin B 12

As part of a WHO collaborative programme the prevalence of anaemia was studied and the serum concentrations of iron, folate, and vitamin B(12) were measured in 1 000 pregnant women from southern India. The results of the study show a high prevalence of anaemia, resulting from iron and folate deficiency with iron deficiency predominating. Interrelationships between these nutrients and their effect on pregnancy and the fetus were investigated. The results indicate that, in comparison with populations in developed countries, there was a high prevalence of iron and vitamin B(12) deficiency in the community, but the state of folate nutrition was similar to that found elsewhere.

Topics: Adolescent; Adult; Anemia, Hypochromic; Female; Folic Acid; Folic Acid Deficiency; Humans; India; Iron; Pregnancy; Pregnancy Complications, Hematologic; Vitamin B 12; Vitamin B 12 Deficiency; World Health Organization

Topics: Age Factors; Aged; Anemia, Hypochromic; Ascorbic Acid; Diet; Female; Folic Acid; Folic Acid Deficiency; Gastrointestinal Diseases; Hemoglobinometry; Humans; Iron; Male; Protein Binding; Salicylates; Scotland; Sex Factors; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Adolescent; Adult; Anemia; Anemia, Hypochromic; Child; Child, Preschool; Diagnosis, Differential; Female; Folic Acid; Folic Acid Deficiency; Humans; Infant; Infant, Newborn; Iron; Male; Nonprescription Drugs; Pregnancy; Substance-Related Disorders; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Anemia, Hypochromic; Animals; Blood Proteins; FIGLU Test; Hemoglobins; Histidine; Homocysteine; Iron; Liver; Male; Methylation; Rats; Transferases; Vitamin B 12

Topics: Anemia; Anemia, Hypochromic; Anemia, Macrocytic; Diphosphoglyceric Acids; Erythrocytes; Folic Acid; Hemoglobins; Humans; Kinetics; Oxygen; Vitamin B 12

Topics: Adult; Aged; Anemia; Anemia, Hypochromic; Erythrocytes; Folic Acid; Folic Acid Deficiency; Follow-Up Studies; Gastrectomy; Hematocrit; Humans; Iron; Male; Middle Aged; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Anemia; Anemia, Hypochromic; Anemia, Macrocytic; Anemia, Pernicious; Erythrocytes; Glutathione; Hemoglobinometry; Humans; Peroxidases; Time Factors; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Adult; Anemia, Aplastic; Anemia, Hypochromic; Duodenal Ulcer; Female; Gastroenterostomy; Humans; Iron; Postoperative Complications; Time Factors; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Anemia, Hypochromic; Folic Acid; Humans; Statistics as Topic; Vitamin B 12

Topics: Adolescent; Age Factors; Anemia; Anemia, Hypochromic; Ascariasis; Blood Proteins; Child; Deficiency Diseases; Female; Folic Acid; Folic Acid Deficiency; Hematocrit; Hemoglobinometry; Humans; Intestinal Diseases, Parasitic; Iron; Male; Philippines; Transferrin; Trichuriasis; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Anemia, Hypochromic; Anemia, Macrocytic; Folic Acid; Iron; Vitamin B 12

Topics: Anemia; Anemia, Hypochromic; Anemia, Macrocytic; Anemia, Pernicious; Blood Proteins; Female; Hematologic Diseases; Humans; Leukemia, Lymphoid; Leukemia, Myeloid; Leukemia, Myeloid, Acute; Leukocyte Count; Liver Cirrhosis; Lupus Erythematosus, Systemic; Lymphoma; Male; Multiple Myeloma; Neoplasms; Polycythemia; Primary Myelofibrosis; Protein Binding; Uremia; Vitamin B 12

Topics: Adolescent; Adult; Aged; Anemia, Hypochromic; Chromium Isotopes; Cobalt Isotopes; Female; Folic Acid; Gastrointestinal Hemorrhage; Hookworm Infections; Humans; Intestinal Absorption; Iron; Iron Isotopes; Male; Middle Aged; Parasite Egg Count; Serum Albumin; Tritium; Vitamin B 12

Topics: Adolescent; Adult; Aged; Anemia; Anemia, Hypochromic; Anemia, Macrocytic; Bone Marrow; Bone Marrow Examination; Crohn Disease; Erythrocytes; Female; Folic Acid; Folic Acid Deficiency; Humans; Iron; Male; Middle Aged; Prospective Studies; Recurrence; Transferrin; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Adolescent; Adult; Aged; Anemia, Hypochromic; Blood Proteins; Body Weight; Bone Diseases; Calcium; Drainage; Dumping Syndrome; Duodenal Ulcer; Female; Folic Acid; Follow-Up Studies; Gastrectomy; Hemoglobinometry; Humans; Malabsorption Syndromes; Male; Middle Aged; Peptic Ulcer Hemorrhage; Postgastrectomy Syndromes; Postoperative Complications; Prospective Studies; Recurrence; Tuberculosis, Pulmonary; Vagotomy; Vitamin B 12; Vomiting

Topics: Anemia, Hypochromic; Animals; Cecum; Diet; Disaccharides; Feces; Gastric Juice; Germ-Free Life; Glycoside Hydrolases; Intestinal Absorption; Intestinal Mucosa; Iron; Rats; Vitamin B 12

Topics: Adolescent; Adult; Aged; Anemia, Hypochromic; Child; Child, Preschool; Chronic Disease; Diarrhea; Duodenal Ulcer; Female; Humans; Iron; Italy; Liver Extracts; Male; Menorrhagia; Menstruation; Metrorrhagia; Middle Aged; Pregnancy; Pregnancy Complications, Hematologic; Stomach Ulcer; Vitamin B 12

Topics: Adolescent; Adult; Anemia, Hypochromic; Calcium, Dietary; Child; Diet; Ethnicity; Female; Folic Acid; Hemoglobins; Humans; India; Inositol; Iron; Male; Nutrition Surveys; South Africa; Transferrin; Vitamin B 12

Topics: Adult; Anemia, Hypochromic; Female; Folic Acid; Humans; Injections, Intravenous; Iron; Iron-Dextran Complex; Male; Thrombophlebitis; Time Factors; Vitamin B 12

Topics: Anemia, Hypochromic; Anemia, Macrocytic; Bone Marrow; Bone Marrow Cells; Child; Folic Acid Deficiency; Follow-Up Studies; Humans; Infant; Iron; Neutrophils; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Anemia, Hypochromic; Drug Combinations; Female; Folic Acid; Humans; Injections, Intramuscular; Iron; Pregnancy; Puerperal Disorders; Sorbitol; Vitamin B 12

Topics: Anemia, Hypochromic; Animal Feed; Animals; Body Weight; Cholestyramine Resin; Depression, Chemical; Diet; Duodenum; Female; Folic Acid; Hematocrit; Hemoglobins; Intestinal Absorption; Iron; Liver; Rats; Rats, Inbred Strains; Spleen; Statistics as Topic; Time Factors; Vitamin B 12

Topics: Adolescent; Adult; Aged; Anemia; Anemia, Hypochromic; Anemia, Macrocytic; Blood Proteins; Carbon Isotopes; Female; Folic Acid; Folic Acid Deficiency; Hemoglobins; Humans; Isomerases; Leukocyte Count; Leukocytes; Male; Malonates; Middle Aged; Neurologic Manifestations; Protein Binding; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Anemia; Anemia, Hypochromic; Anemia, Macrocytic; Asian People; China; Diet; Erythrocytes; Erythropoiesis; Ethnicity; Female; Folic Acid; Hemoglobinometry; Humans; India; Malaysia; Neutrophils; Parity; Pregnancy; Pregnancy Complications, Hematologic; Racial Groups; Singapore; Vitamin B 12; Vitamin B 12 Deficiency; White People

Topics: Anemia, Hypochromic; Bone Diseases; Family Practice; Female; Follow-Up Studies; Gastrectomy; Hemoglobins; Humans; Male; Postgastrectomy Syndromes; Vitamin B 12

Topics: Adolescent; Adult; Anemia, Hypochromic; Bone Marrow Cells; Erythrocytes; Female; Folic Acid; Folic Acid Deficiency; Hematocrit; Hemoglobins; Hemosiderin; Humans; Iron; Neutrophils; Pregnancy; Pregnancy Complications, Hematologic; Puerperal Disorders; Transferrin; Venezuela; Vitamin B 12

Topics: Anemia, Hypochromic; Bile Acids and Salts; Body Weight; Celiac Disease; Crohn Disease; Diarrhea; Diet Therapy; Dietary Fats; Dietary Proteins; Humans; Hypoproteinemia; Ileum; Intestinal Absorption; Jejunum; Lipid Metabolism; Nutrition Disorders; Serum Albumin; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Adult; Aged; Anemia, Hypochromic; Bone Marrow; Erythrocytes; Erythropoiesis; Female; Folic Acid; Humans; Iron; Male; Middle Aged; Protein Binding; Vitamin B 12

Topics: Analysis of Variance; Anemia, Hypochromic; Anemia, Pernicious; Bone Marrow; Bone Marrow Cells; Cobalt Isotopes; Germany, West; Hematocrit; Hemoglobinometry; Humans; Intestinal Absorption; Iron; Iron Isotopes; Macrophages; Postgastrectomy Syndromes; Transferrin; Vitamin B 12; Whole-Body Counting

Topics: Adult; Anemia, Hypochromic; Anemia, Macrocytic; Female; Folic Acid; Humans; Pregnancy; Puerperal Disorders; Vitamin B 12

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

Topics: Anemia, Hypochromic; Black People; Central America; Erythrocyte Count; Female; Folic Acid; Folic Acid Deficiency; Hematocrit; Hemoglobinometry; Humans; Indians, South American; Iron; Population Surveillance; Pregnancy; Pregnancy Complications; Serum Albumin; South America; Transferrin; Vitamin B 12; Vitamin B 12 Deficiency; White People

Topics: Anemia, Hypochromic; Animals; Calcium; Cattle; Cattle Diseases; Copper; Deficiency Diseases; Iron; Lice Infestations; Magnesium; Magnesium Deficiency; Pneumonia; Seizures; Vitamin B 12

Topics: Aged; Anemia, Hypochromic; Anemia, Macrocytic; Female; Folic Acid; Folic Acid Deficiency; Hematocrit; Hemoglobinometry; Hemoglobins; Humans; Learning; Male; Memory; Psychological Tests; Vitamin B 12; Vitamin B 12 Deficiency; Wales

Vitamin B(12) levels in erythrocytes were low in untreated hypochromic anaemia, rose to abnormally high levels during therapy with iron alone, and finally slowly fell to normal. These changes were similar to those previously found in pernicious anaemia in response to vitamin B(12) therapy and in folate-deficiency anaemia in response to folic acid, thus changes in erythrocyte B(12) levels are not always due directly to changes in B(12) metabolism but may be secondary to changes in the levels of other haematinic factors.

Topics: Anemia, Hypochromic; Biological Assay; Erythrocytes; Humans; Iron; Vitamin B 12

Topics: Anemia, Hypochromic; Erythrocytes, Abnormal; Gastrectomy; Hemoglobins; Humans; Iron; Methods; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Anemia, Hypochromic; Carbonates; Chlorides; Female; Folic Acid; Humans; Iron; Male; Pyridoxine; Sulfates; Vitamin B 12; Vitamins

Topics: Anemia, Hypochromic; Dosage Forms; Drug Combinations; Drug Compounding; Folic Acid; Folic Acid Deficiency; Hematopoiesis; Hemochromatosis; Humans; Infusions, Parenteral; Iron; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Adult; Anemia; Anemia, Hypochromic; Anemia, Sideroblastic; Blood Cell Count; Female; Folic Acid; Gestational Age; Hematocrit; Hemoglobins; Humans; Iron; Nutrition Surveys; Philippines; Pregnancy; Pregnancy Complications, Hematologic; Socioeconomic Factors; Transferrin; Vitamin B 12

Topics: Anemia, Hypochromic; Animals; Ascorbic Acid; Calcium; Cobalt; Copper; Dextrans; Female; Folic Acid; Hematocrit; Hemoglobins; Horse Diseases; Horses; Iron; Male; Sulfates; Vitamin B 12

Topics: Adolescent; Adult; Aged; Anemia; Anemia, Hypochromic; Biliary Tract Diseases; Biometry; Cardiovascular Diseases; Erythrocyte Count; Erythrocytes; Erythrocytes, Abnormal; Female; Gastrointestinal Diseases; Hematologic Diseases; Hemophilia A; Humans; Leukemia; Liver Diseases; Lung Diseases; Male; Middle Aged; Neoplasms; Pancreatic Diseases; Splenectomy; Thalassemia; Thyroid Diseases; Urologic Diseases; Vitamin B 12

Topics: Aged; Anemia, Hypochromic; Anemia, Sideroblastic; Blood Platelets; Bone Marrow Cells; Erythrocyte Count; Female; Folic Acid; Hemoglobinometry; Humans; Iron; Leukemia; Leukemia, Myeloid; Leukemia, Myeloid, Acute; Leukocyte Count; Male; Middle Aged; Multiple Myeloma; Reticulocytes; Vitamin B 12

Topics: Alcohol Oxidoreductases; Anemia, Hypochromic; Bone Marrow; Bone Marrow Cells; Child; Erythrocytes; Folic Acid; Humans; Infant; Iron; Nucleotides; Vitamin B 12

Topics: Age Factors; Aged; Anemia; Anemia, Hypochromic; Anemia, Macrocytic; Anemia, Sideroblastic; Erythrocytes; Female; Folic Acid; Hemoglobins; Humans; Iron; Male; Sex Factors; Vitamin B 12; Wales

Topics: Aged; Anemia, Hypochromic; Anemia, Pernicious; Arthritis, Rheumatoid; Circadian Rhythm; Dementia; Female; Femoral Fractures; Folic Acid; Hemoglobins; Humans; Iron; Male; Urea; Vitamin B 12; Wales

Topics: Anemia, Hypochromic; Erythrocytes; Female; Folic Acid; Folic Acid Deficiency; Hemoglobinometry; Humans; Iron; Leukocyte Count; Male; Neutrophils; Vitamin B 12

Topics: Anemia, Hypochromic; Anemia, Macrocytic; Erythrocyte Count; Female; Folic Acid; Folic Acid Deficiency; Hemoglobinometry; Humans; Injections, Intravenous; Iron; Pregnancy; Pregnancy Complications, Hematologic; Reticulocytes; Urinary Tract Infections; Vitamin B 12

Topics: Adult; Anemia, Hypochromic; Erythropoiesis; Female; Hemoglobins; Humans; Iron; Liver Extracts; Male; Middle Aged; Nutrition Disorders; Vitamin B 12

Topics: Acrylates; Adolescent; Adult; Aged; Aminosalicylic Acids; Anemia; Anemia, Hypochromic; Anemia, Macrocytic; Antitubercular Agents; Erythropoiesis; Female; FIGLU Test; Folic Acid; Folic Acid Deficiency; Humans; Imidazoles; Iron; Isoniazid; Male; Middle Aged; Streptomycin; Tuberculosis; Vitamin B 12

Topics: Anemia, Aplastic; Anemia, Hemolytic; Anemia, Hypochromic; Anemia, Sickle Cell; Anemia, Sideroblastic; Blood Cell Count; Blood Platelets; Child; Chronic Disease; Erythrocyte Count; Erythrocytes; FIGLU Test; Folic Acid; Folic Acid Deficiency; Humans; Leukocyte Count; Vitamin B 12

Topics: Anemia, Hypochromic; Ascorbic Acid; Folic Acid; Humans; Iron; Pyridoxine; Vitamin B 12; Vitamins

Topics: Adult; Aged; Alkaline Phosphatase; Anemia, Hypochromic; Body Weight; Calcium; Duodenal Ulcer; Female; Follow-Up Studies; Gastroenterostomy; Hemoglobins; Humans; Male; Metabolism; Middle Aged; Osteomalacia; Sex Factors; Time Factors; Tuberculosis, Pulmonary; Vagotomy; Vitamin B 12

Topics: Agammaglobulinemia; Agranulocytosis; Anemia; Anemia, Hemolytic; Anemia, Hypochromic; Anemia, Macrocytic; Anemia, Sideroblastic; Antineoplastic Agents; Bone Marrow Diseases; Elliptocytosis, Hereditary; Female; Folic Acid; Folic Acid Deficiency; Humans; Iron; Myeloproliferative Disorders; Polycythemia Vera; Pregnancy; Primary Myelofibrosis; Spherocytosis, Hereditary; Thalassemia; Vitamin B 12; Vitamin B 12 Deficiency

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; Aged; Anemia, Hypochromic; Anemia, Macrocytic; Biopsy; Bone and Bones; Calcium; Celiac Disease; Disability Evaluation; Dumping Syndrome; Female; Folic Acid Deficiency; Follow-Up Studies; Gastric Mucosa; Gastritis; Humans; Lactose Intolerance; Male; Middle Aged; Nutrition Disorders; Postgastrectomy Syndromes; Vitamin B 12

Topics: Adrenal Cortex Hormones; Androstanes; Anemia, Aplastic; Anemia, Hemolytic; Anemia, Hypochromic; Anemia, Macrocytic; Anemia, Pernicious; Ascorbic Acid; Blood Transfusion; Humans; Iron; Iron-Dextran Complex; Ketones; Splenectomy; Vitamin B 12

Topics: Age Factors; Aged; Anemia; Anemia, Hypochromic; Arthritis, Rheumatoid; Blood Chemical Analysis; Blood Proteins; Blood Sedimentation; Bronchitis; England; Feces; Female; Folic Acid; Folic Acid Deficiency; Health Surveys; Hematologic Diseases; Hemoglobins; Hospitalization; Humans; Iron; Middle Aged; Neoplasms; Sex Factors; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Anemia, Hypochromic; Anemia, Macrocytic; Erythrocytes; Folic Acid; Folic Acid Deficiency; Hemoglobinometry; Humans; Iron; Vitamin B 12

Topics: Adolescent; Adrenal Cortex Hormones; Adult; Aged; Anabolic Agents; Anemia, Aplastic; Anemia, Hypochromic; Anemia, Macrocytic; Female; Humans; Iron; Male; Middle Aged; Vitamin B 12

Topics: Adult; Aged; Anemia, Hemolytic; Anemia, Hypochromic; Anemia, Pernicious; Dapsone; Dermatitis Herpetiformis; Folic Acid; Hemolysis; Humans; Iron; Malabsorption Syndromes; Middle Aged; Oxygen; Vitamin B 12

Topics: Anemia, Hypochromic; Female; Folic Acid; Humans; Iron; Pregnancy; Pregnancy Complications, Hematologic; Puerperal Disorders; Sorbitol; Vitamin B 12

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: Alcoholism; Anemia, Hypochromic; Bone Diseases; Calcium; Female; Humans; Hypocalcemia; Intestinal Absorption; Malabsorption Syndromes; Middle Aged; Vitamin B 12

Topics: Adult; Anemia, Hypochromic; Anemia, Macrocytic; Blood Transfusion; Bone Marrow Examination; Erythrocyte Count; Erythropoiesis; Female; Hematocrit; Hemoglobinometry; Humans; Iron; Nutrition Disorders; Nutritional Requirements; Schilling Test; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Aged; Anemia, Hypochromic; Anemia, Pernicious; Deglutition Disorders; Exanthema; Female; Humans; Middle Aged; Mouth Mucosa; Oral Manifestations; Tongue Diseases; Vitamin B 12

Topics: Anemia; Anemia, Hypochromic; Bone Marrow Cells; Bone Marrow Examination; Child, Preschool; Deficiency Diseases; Dietary Proteins; Egypt; Erythrocytes, Abnormal; Erythropoiesis; Folic Acid; Folic Acid Deficiency; Hemoglobinometry; Humans; Infant; Iron; Iron-Dextran Complex; Kwashiorkor; Nutrition Disorders; Protein Deficiency; Reticulocytes; Vitamin B 12; Vitamin E

Topics: Acetates; Anemia, Hemolytic; Anemia, Hypochromic; Anemia, Macrocytic; Animals; Blood Cell Count; Creatine; Erythrocytes; Erythropoiesis; Female; Fructose-Bisphosphate Aldolase; Hemoglobinometry; Humans; Male; Rabbits; Reticulocytes; Vitamin B 12

Topics: Anemia, Hypochromic; Anemia, Pernicious; Anemia, Sideroblastic; Blood Proteins; Carbon Isotopes; Erythrocytes; Female; Globins; Glycine; Heme; Hemoglobins; Humans; Iron; Male; Porphyrins; Pyridoxine; Thalassemia; Vitamin B 12

Topics: Adult; Age Factors; Aged; Anemia; Anemia, Hypochromic; Anemia, Macrocytic; Blood Proteins; Chronic Disease; Female; Folic Acid; Hematocrit; Hemoglobinometry; Humans; Iron; Male; Middle Aged; Protein Deficiency; Pyridoxine; Serum Albumin; Serum Globulins; Sex Factors; Thiamine; Vitamin B 12; Vitamins

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; Biological Assay; Female; Folic Acid; Humans; Male; Neutrophils; Vitamin B 12

Topics: Anemia, Hypochromic; Folic Acid; Folic Acid Deficiency; Humans; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Absorption; Anemia, Hypochromic; Calcium; Calcium Isotopes; Chromium Isotopes; Cobalt Isotopes; Dietary Fats; Gastrointestinal Diseases; Gastrointestinal Neoplasms; Iodine Isotopes; Iron; Iron Isotopes; Occult Blood; Protein-Losing Enteropathies; Radioisotopes; Radionuclide Imaging; Schilling Test; Tritium; 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: Adolescent; Adult; Aged; Anemia, Hypochromic; Autoantibodies; Female; Gastric Acidity Determination; Gastric Juice; Gastric Mucosa; Gastritis; Histamine; Humans; Intestinal Absorption; Iron; Male; Middle Aged; Pepsin A; Secretory Rate; Vitamin B 12

Topics: Anemia, Hypochromic; Deferoxamine; Erythropoiesis; Female; Fluorescent Antibody Technique; Folic Acid; Humans; Iron; Male; Vitamin B 12; Xylose

Topics: Adult; Aged; Anemia, Hypochromic; Anemia, Macrocytic; Anemia, Pernicious; Bone Marrow Examination; Cestode Infections; Erythrocytes; Female; Hematocrit; Hemoglobinometry; Humans; Hyperthyroidism; Hypothyroidism; Iron; Kidney Failure, Chronic; Leukocyte Count; Male; Middle Aged; Neoplasms; Pregnancy; Transferases; Vitamin B 12

Topics: Adult; Anemia, Hypochromic; Ascorbic Acid; Female; Humans; Intestinal Absorption; Iron; Male; Middle Aged; Nutrition Disorders; Vitamin B 12; Vitamin B Complex; Vitamins

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: Anemia, Hypochromic; Avitaminosis; Body Weight; Carbohydrate Metabolism; Diarrhea; Disaccharides; Edema; Feces; Folic Acid; Glucose; Humans; Hypocalcemia; Hypokalemia; Hypoproteinemia; Intestinal Absorption; Intestine, Small; Iron; Malabsorption Syndromes; Vitamin A; Vitamin B 12; Vitamin K; Xylose

Topics: Adult; Aged; Anemia, Hypochromic; Anemia, Macrocytic; Anemia, Pernicious; Anemia, Sideroblastic; Cell Membrane; Child; Erythrocytes; Erythropoiesis; Female; Hemagglutination; Humans; Isoantibodies; Isoantigens; Male; Middle Aged; Umbilical Cord; Vitamin B 12

Topics: Adolescent; Adult; Anemia; Anemia, Hypochromic; Anemia, Macrocytic; Bilirubin; Blood Cell Count; Blood Proteins; Child; Child, Preschool; Cholesterol; Diet Therapy; Female; Folic Acid; Folic Acid Deficiency; Health Surveys; Hematocrit; Hemoglobinometry; Humans; Intestinal Diseases, Parasitic; Iron; Male; Pregnancy; Pregnancy Complications, Hematologic; Trinidad and Tobago; Vitamin B 12

Topics: Anemia, Hypochromic; Anemia, Macrocytic; Folic Acid; Folic Acid Deficiency; Gastrectomy; Histidine; Humans; Iron; Time Factors; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Anemia, Hypochromic; Autoradiography; Bone Marrow; Bone Marrow Cells; Cell Nucleus; Erythrocytes; Folic Acid; Humans; Iron; Iron Isotopes; Pyridoxine; Vitamin B 12

Topics: Adolescent; Adult; Anemia; Anemia, Hypochromic; Blood Sedimentation; Colitis, Ulcerative; Female; Folic Acid; Hemoglobinometry; Humans; Male; Middle Aged; Serum Albumin; Sex; Vitamin B 12

Topics: Adult; Anemia, Hypochromic; Anemia, Macrocytic; Bone Marrow Examination; Female; FIGLU Test; Folic Acid Deficiency; Hematocrit; Hemoglobinometry; Humans; Iron; Pregnancy; Pregnancy Complications, Hematologic; Puerperal Disorders; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Adult; Aged; Anemia, Hypochromic; Female; Folic Acid; Folic Acid Deficiency; Hemoglobinometry; Humans; Male; Middle Aged; Vitamin B 12

Topics: Adult; Aged; Anemia, Hypochromic; Celiac Disease; Crohn Disease; Female; Humans; Iron; Malabsorption Syndromes; Male; Middle Aged; Postoperative Complications; Vitamin B 12; Xylose

Topics: Anemia, Hypochromic; Anemia, Macrocytic; Diagnosis, Differential; Folic Acid; Hemoglobins; Hookworm Infections; Humans; Intestinal Absorption; Megakaryocytes; Protein Deficiency; Sprue, Tropical; Vitamin B 12

Topics: Anemia, Hypochromic; Blood Cells; Blood Chemical Analysis; Diet; Female; Hemoglobins; Humans; Pregnancy; Pregnancy Complications, Hematologic; Trinidad and Tobago; Vitamin B 12

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; Chromium Isotopes; Feces; Female; Gastrointestinal Hemorrhage; Gastroscopy; Hemoglobinometry; Humans; Iron; Male; Middle Aged; Postgastrectomy Syndromes; Vitamin B 12

Topics: Adolescent; Adult; Anemia, Hypochromic; Ascorbic Acid; Female; Humans; Iron; Male; Vitamin B 12

Topics: Anemia; Anemia, Hemolytic; Anemia, Hypochromic; Anemia, Macrocytic; Anemia, Pernicious; Folic Acid Deficiency; Humans; Injections, Intramuscular; Injections, Intravenous; Iron; Splenectomy; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Adolescent; Adult; Africa, Southern; Anemia; Anemia, Hypochromic; Anemia, Macrocytic; Anemia, Sideroblastic; Asia; Australia; Europe; Female; Folic Acid; Gestational Age; Humans; Iron; Israel; Mexico; Pregnancy; Pregnancy Complications, Hematologic; United States; Vitamin B 12

Topics: Anemia, Hypochromic; Child, Preschool; Humans; Iron; Vitamin B 12

Macrogranulocytic and/or erythroid megaloblastic bone marrow changes which could not be accurately predicted from the hematologic findings in the blood were present in 25% of 305 mildly to moderately anemic pregnant women attending a public antepartum clinic in Montreal. Iron deficiency was the primary cause of anemia in most instances. Serum folate activity of less than 4.1 ng./ml. and/or serum vitamin B(12) levels of less than 100 pg./ml. were present in 90% of the 77 patients having these bone marrow changes, whereas approximately one-third of 228 patients with normoblastic marrow had these low values. Red cell folate did not correlate as well as serum folate activity with bone marrow changes. After treatment with oral folic acid in the range of 0.2 mg. to 0.8 mg., daily, for seven to 14 days, the megaloblastic and macrogranulocytic changes in patients with low serum folate activity and normal serum vitamin B(12) values disappeared in 15 of 21 patients. Of five women having both low folate and vitamin B(12) values, three failed to respond and two showed only partial improvement after 0.4 mg. of folic acid daily, per os, for 10 days. The average diet of these anemic women was suboptimal in folate and in iron.

Topics: Anemia, Hypochromic; Female; Folic Acid; Folic Acid Deficiency; Humans; In Vitro Techniques; Pregnancy; Pregnancy Complications, Hematologic; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Anemia, Hypochromic; Ascorbic Acid; Child; Child, Preschool; Female; Humans; Infant; Iron; Male; 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: Adolescent; Adult; Aged; Anemia, Hypochromic; Anemia, Macrocytic; Antitubercular Agents; Blood; Bone Marrow Examination; Female; Folic Acid; Folic Acid Deficiency; Humans; Iron; Male; Middle Aged; Tuberculosis; Tuberculosis, Lymph Node; Tuberculosis, Osteoarticular; Tuberculosis, Pulmonary; Tuberculosis, Renal; Vitamin B 12

Topics: Anemia, Hemolytic; Anemia, Hypochromic; Anemia, Macrocytic; Anemia, Sideroblastic; Animals; Erythrocytes; Erythropoiesis; Female; Fetus; Iron; Pregnancy; Pregnancy, Animal; Rats; Transferrin; Vitamin B 12

Nine patients are described, four men and five women, aged between 14 and 62 years, who presented with symptoms of severe anaemia. Deficiencies of iron and folic acid were subsequently demonstrated in each case. Although malabsorption was not initially suspected, further investigations showed an abnormally high excretion of faecal fat in seven cases. Anaemias which are ;unexplained' or which show a suboptimal response to treatment should be investigated from the viewpoint of intestinal dysfunction. Such anaemias are not a particularly uncommon problem.

Topics: Adolescent; Adult; Anemia; Anemia, Hypochromic; Celiac Disease; Female; Folic Acid; Glucose Tolerance Test; Humans; Iron; Male; Occult Blood; Vitamin B 12

Topics: Alcoholism; Anemia; Anemia, Hypochromic; Blood Chemical Analysis; Blood Volume; Bone Marrow Examination; Erythropoiesis; Folic Acid; Folic Acid Deficiency; Gastric Juice; Hematocrit; Hemochromatosis; Hemolysis; Humans; Iron; Liver; Liver Cirrhosis; Liver Diseases; Melena; Metabolism; Splenomegaly; Vitamin B 12

Topics: Anemia; Anemia, Hypochromic; Autoantibodies; Autoimmune Diseases; Biological Assay; Biopsy; Cobalt Isotopes; Complement Fixation Tests; Fluorescent Antibody Technique; Folic Acid; Gastric Acidity Determination; Gastritis; Gastritis, Atrophic; Humans; Intestinal Absorption; Pathology; Thyroid Gland; Vitamin B 12

Topics: Anemia; Anemia, Hypochromic; Biological Transport; Blood; Cobalt Isotopes; Feces; Gastrointestinal Absorption; Hematologic Diseases; Humans; Intestinal Absorption; Iron; Metabolism; Radiometry; Urine; Vitamin B 12

Topics: Anemia; Anemia, Hypochromic; Blood Cell Count; Blood Proteins; Bone Marrow Cells; Child; Diagnosis; Diet; Diet Therapy; Dietary Proteins; Drug Therapy; FIGLU Test; Folic Acid; Hemoglobinometry; Humans; Infant; Kwashiorkor; Proteins; Uganda; Vitamin B 12

Topics: Ancylostoma; Anemia; Anemia, Hypochromic; Animals; Blood Circulation; Blood Flow Velocity; Cobalt Isotopes; Hemodynamics; Hookworm Infections; Humans; Intestinal Absorption; Isotopes; Liver; Liver Function Tests; Metabolism; Radiometry; Serum Albumin; Serum Albumin, Radio-Iodinated; Vitamin B 12

Topics: Anemia; Anemia, Hypochromic; Anemia, Macrocytic; Blood; Blood Cell Count; Bone Marrow Examination; Child; Egypt; Hematocrit; Hemoglobins; Humans; Infant; Kwashiorkor; Protein Deficiency; Vitamin B 12; Vitamin E

Topics: Anemia; Anemia, Hypochromic; Anemia, Macrocytic; Anemia, Megaloblastic; Blood; Drug Therapy; Folic Acid; Hematopoiesis; Humans; Vitamin B 12

Topics: Altitude; Anemia; Anemia, Hypochromic; Blood Cell Count; Blood Platelets; Body Height; Body Weight; Dextrans; Diet; Folic Acid; Hemoglobinometry; Humans; Japan; Occupations; Periodicity; Reference Values; Reticulocytes; Seasons; Sex; Sports; Vitamin B 12

Topics: Anemia, Hypochromic; Anemia, Macrocytic; Blood Cell Count; Bone Marrow; Child; Chromatography; Chromosomes; Female; Folic Acid; Humans; Leukemia; Neutrophils; Peroxidases; Porphyrins; Staining and Labeling; Succinate Dehydrogenase; Uracil; Uracil Nucleotides; Urine; Vitamin B 12

Topics: Anemia, Hemolytic; Anemia, Hypochromic; Blood; Blood Proteins; Child, Preschool; Chromium Isotopes; Erythrocyte Count; Hematocrit; Hemoglobins; Humans; Infant; Iron; Kwashiorkor; Lebanon; Vitamin B 12; Vitamin E; Vitamin E Deficiency

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

Topics: Anemia, Hypochromic; Blood; Glomerulonephritis; Humans; Iron; 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: Alkaline Phosphatase; Anemia; Anemia, Hypochromic; Blood; Cobalt Isotopes; Erythropoiesis; Folic Acid; Folic Acid Deficiency; Histidine; Humans; Iron; Primary Myelofibrosis; Tritium; Vitamin B 12; Vitamin B Deficiency

Topics: Adolescent; Alkalies; Anemia; Anemia, Hypochromic; Anemia, Pernicious; Blood Chemical Analysis; Erythrocytes; Gastrectomy; Geriatrics; Hematologic Diseases; Humans; Lactobacillus; Leukemia; Leukemia, Lymphoid; Leukemia, Myeloid; Polycythemia Vera; Vitamin B 12; Vitamins

Topics: Adolescent; Anemia; Anemia, Hypochromic; Blood; Esophagoplasty; Esophagus; Humans; Iron; Jejunum; Surgical Procedures, Operative; Urine; Vitamin B 12; Xylose

Topics: Anemia; Anemia, Hemolytic; Anemia, Hypochromic; Anemia, Pernicious; Blood Coagulation; Blood Proteins; Chloramphenicol; Epidemiology; Epoetin Alfa; Erythropoietin; Haptoglobins; Hematologic Diseases; Hematology; Hemochromatosis; Humans; Iron-Dextran Complex; Leukemia; Polycythemia; Thromboplastin; Vitamin B 12

Topics: Absorption; Agricultural Workers' Diseases; Anemia; Anemia, Hypochromic; Biopsy; Blood Cell Count; Blood Chemical Analysis; Bone Marrow; Digestion; Fatty Acids; Feces; Folic Acid; Hemoglobins; Hookworm Infections; Humans; Intestinal Absorption; Intestines; Jejunum; Urine; Vitamin B 12; Xylose

Topics: Adenosine Triphosphate; Adrenocorticotropic Hormone; Aminocaproates; Aminocaproic Acid; Anabolic Agents; Anemia; Anemia, Hemolytic; Anemia, Hypochromic; Anemia, Macrocytic; Anemia, Pernicious; Blood Transfusion; Bone Marrow Transplantation; Hematologic Diseases; Hematology; Hemophilia A; Humans; Iron; Leukemia; Methandrostenolone; Methyltestosterone; Nandrolone; Purpura; Purpura, Thrombocytopenic; Steroids; Vitamin B 12

Topics: Anemia; Anemia, Hypochromic; Anemia, Macrocytic; Anemia, Pernicious; Female; Folic Acid; Humans; Iron; Leukocytosis; Pelger-Huet Anomaly; Polycythemia Vera; Pregnancy; Pregnancy Complications; Pregnancy Complications, Hematologic; Thalassemia; 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: Anemia; Anemia, Hypochromic; Anemia, Sideroblastic; Dithiazanine; Erythrocyte Count; Genetic Diseases, X-Linked; Humans; Iodides; Iron; Trichuriasis; Vitamin B 12

Topics: Anemia; Anemia, Hypochromic; Anemia, Macrocytic; Anemia, Pernicious; Humans; Hypothyroidism; Iron; Myxedema; Thyroid Hormones; Vitamin B 12

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: Alcoholism; Anemia; Anemia, Hypochromic; Avitaminosis; Cholestyramine Resin; Common Bile Duct; Diet; Diet Therapy; Diuretics; Folic Acid; Folic Acid Deficiency; Gastrointestinal Hemorrhage; Humans; Hydrochlorothiazide; Ion Exchange Resins; Jaundice; Liver Cirrhosis; Liver Cirrhosis, Biliary; Postoperative Complications; Prothrombin Time; Vitamin B 12; Vitamin B Complex; Vitamin K

Topics: Anemia; Anemia, Hypochromic; Arthritis; Arthritis, Rheumatoid; Cobalt; Corrinoids; Iron; Vitamin B 12

Topics: Aging; Anemia; Anemia, Hypochromic; Anemia, Macrocytic; Avitaminosis; Biomedical Research; Calcium; Enzymes; Erythrocytes; Erythrocytes, Abnormal; Folic Acid; Geriatrics; Spherocytes; Vitamin B 12; Vitamin B Complex; Vitamin D; Vitamins

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

Topics: Anemia; Anemia, Hypochromic; Anemia, Pernicious; Anxiety; Anxiety Disorders; Arthritis; Arthritis, Rheumatoid; Bone Marrow Examination; Depression; Depressive Disorder; Drug Therapy; Humans; Neurotic Disorders; Paranoid Disorders; Vitamin B 12; Vitamin B 12 Deficiency; Xylose

Topics: Alkaline Phosphatase; Anemia; Anemia, Hypochromic; Anemia, Pernicious; Depressive Disorder; Hematinics; Humans; Intestines; Liver; Metabolism; Vitamin B 12

Topics: Adolescent; Anemia; Anemia, Hypochromic; Anemia, Macrocytic; Breast Neoplasms; Bronchopneumonia; Child; Deficiency Diseases; Female; Folic Acid; Gastroenterology; Geriatrics; Hemorrhage; Humans; Liver Diseases; Liver Extracts; Multiple Myeloma; Nucleosides; Postpartum Hemorrhage; Postpartum Period; Rheumatic Fever; Sepsis; Toxicology; Virus Diseases; Vitamin B 12; Vitamin B Complex

Topics: Anemia; Anemia, Hypochromic; Animals; Coenzymes; Dogs; Iron; Rabbits; Rats; Research; Vitamin B 12

Topics: Absorption; Anemia; Anemia, Hypochromic; Anemia, Macrocytic; Anemia, Pernicious; Blood Chemical Analysis; Bone Marrow Examination; Cobalt Isotopes; Folic Acid; Folic Acid Deficiency; Gastrectomy; Humans; Postgastrectomy Syndromes; Vitamin B 12

Topics: Anemia; Anemia, Hypochromic; Anemia, Macrocytic; Blood Proteins; Copper; Drug Therapy; Female; Hematocrit; Hemoglobinometry; Humans; Iron; Postpartum Hemorrhage; Postpartum Period; Pregnancy; Pregnancy Complications; Pregnancy Complications, Hematologic; Shock, Hemorrhagic; Vitamin B 12

Topics: Anemia; Anemia, Hypochromic; Female; Folic Acid; Hematinics; Humans; Iron; Pregnancy; Pregnancy Complications, Hematologic; Vitamin B 12

Topics: Anemia; Anemia, Hypochromic; Anemia, Iron-Deficiency; Anemia, Macrocytic; Blood Platelets; Bone Marrow Cells; Drug Therapy; Epoetin Alfa; Erythropoietin; FIGLU Test; Folic Acid; Folic Acid Deficiency; Glutamates; Hemoglobins; Humans; Infant; Infusions, Parenteral; Injections, Intravenous; Iron; Iron-Dextran Complex; Megakaryocytes; Reticulocytes; Thrombocytopenia; Thrombocytosis; Vitamin B 12

Topics: Anemia; Anemia, Hypochromic; Anemia, Pernicious; Biological Assay; Blood Chemical Analysis; Chromatography; Erythrocytes; Folic Acid; Folic Acid Deficiency; Hematologic Diseases; Humans; Lactobacillus; Metabolism; Methotrexate; Vitamin B 12

Topics: Anemia; Anemia, Hypochromic; Anemia, Iron-Deficiency; Breast Feeding; Female; Folic Acid; Humans; Postpartum Period; Pregnancy; Puerperal Disorders; Vitamin B 12

Topics: Anemia; Anemia, Hypochromic; Humans; Iron; Peptic Ulcer; Postgastrectomy Syndromes; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Agammaglobulinemia; Anemia; Anemia, Hypochromic; Anemia, Pernicious; Blood Proteins; Electrophoresis; Geriatrics; Humans; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Anemia; Anemia, Hypochromic; Anemia, Pernicious; Blood Cell Count; Folic Acid; Hemoglobinometry; Humans; Iron; Reticulocytes; Sulfates; Thalassemia; Vitamin B 12

Topics: Anemia; Anemia, Hypochromic; Blood Sedimentation; Chromium Isotopes; Colitis, Ulcerative; Feces; Gastrointestinal Hemorrhage; Hemorrhage; Humans; Iron; Iron Isotopes; Occult Blood; Radioisotopes; Radionuclide Imaging; Vitamin B 12

Topics: Adenine Nucleotides; Adenosine Triphosphatases; Adenosine Triphosphate; Anemia; Anemia, Hypochromic; Blood Transfusion; Deficiency Diseases; Humans; Infant; Liver Extracts; NAD; Vitamin B 12

Topics: Anemia; Anemia, Hypochromic; Anemia, Macrocytic; Duodenal Ulcer; Gastrectomy; Humans; Pathology; Peptic Ulcer; Postgastrectomy Syndromes; Vitamin B 12

Topics: Anemia; Anemia, Hypochromic; Anemia, Iron-Deficiency; Ascorbic Acid; Blood Transfusion; Erythrocytes; Humans; Statistics as Topic; Vitamin B 12; Vitamin B Complex

Topics: Anemia; Anemia, Hypochromic; Anemia, Pernicious; Hematinics; Humans; Iron; Leukemia; Serum; Thrombocytopenia; Vitamin B 12; Vitamins

Topics: Anemia; Anemia, Hypochromic; Child; Humans; Infant; Intestine, Small; Intestines; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Anemia; Anemia, Hypochromic; Anemia, Iron-Deficiency; Corrinoids; Humans; Vitamin B 12

Topics: Anemia; Anemia, Hypochromic; Corrinoids; Humans; Iron; Medical Records; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Anemia; Anemia, Hypochromic; Corrinoids; Hematologic Diseases; Humans; Polycythemia Vera; Vitamin B 12

Topics: Anemia; Anemia, Hypochromic; Animals; Corrinoids; Dogs; Hematinics; Stomach; Vitamin B 12

Topics: Anemia; Anemia, Hypochromic; Anemia, Sideroblastic; Child; Genetic Diseases, X-Linked; Humans; Infant; Vitamin B 12; Vitamin B Complex

Topics: Anemia; Anemia, Hypochromic; Humans; Iron; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Anemia; Anemia, Hypochromic; Anemia, Pernicious; Cobalt; Corrinoids; Hematinics; Humans; Liver Extracts; Vitamin B 12

Topics: Anemia; Anemia, Hypochromic; Anemia, Iron-Deficiency; Anemia, Sideroblastic; Chlorophyll; Genetic Diseases, X-Linked; Humans; Iron; Vitamin B 12

Topics: Anemia; Anemia, Hypochromic; Cobalt; Corrinoids; Hematinics; Humans; Iron; Vitamin B 12

Topics: Anemia; Anemia, Hypochromic; Anemia, Iron-Deficiency; Folic Acid; Hematinics; Hematologic Diseases; Humans; Vitamin B 12