vitamin-b-12 and Cholelithiasis

Ineffective erythropoiesis and intramedullary hemolysis are the two important results of pernicious anemia. Hemolysis is one of the risk factors in the formation of gallbladder stones.. The frequency of gallstones was searched in 59 patients with pernicious anemia and in 54 healthy subjects.. Nineteen (32.2%) patients in the pernicious anemia group and three (5.5%) patients in the control group were detected to have gallstones. Pernicious anemia patients with and without gallbladder stones were also compared for mean corpuscular volume, hemoglobin, unconjugated bilirubin, lactic dehydrogenase, and vitamin B12 levels but no statistically significant difference was encountered.. Apart from other risk factors, pernicious anemia itself increases the frequency of gallbladder stones. Should patients with pernicious anemia develop upper-abdominal pain or other symptoms referable to biliary tract disease, a high index of suspicion for gallstone-related disease should be maintained.

Topics: Adult; Aged; Anemia, Pernicious; Cholelithiasis; Female; Hemoglobins; Humans; Male; Middle Aged; Prevalence; Vitamin B 12

Patients with ileal disease, bypass, or resection are at increased risk for developing gallstones. In ileectomized rats, bilirubin secretion rates into bile are elevated, most likely caused by increased colonic bile salt levels, which solubilize unconjugated bilirubin, prevent calcium complexing, and promote its absorption and enterohepatic cycling. The hypothesis that ileal disease or resection engenders the same pathophysiology in humans was tested.. Sterile gallbladder bile samples were obtained intraoperatively from 29 patients with Crohn's disease and 19 patients with ulcerative colitis. Bilirubin, total calcium, biliary lipids, beta-glucuronidase activities, and cholesterol saturation indices in bile were measured, and markers of hemolysis and ineffective erythropoiesis in blood were assessed.. Bilirubin conjugates, unconjugated bilirubin, and total calcium levels were increased 3-10-fold in bile of patients with ileal disease and/or resection compared with patients with Crohn's colitis or ulcerative colitis. Biliary bilirubin concentrations correlated positively with the anatomic length and duration of ileal disease. Endogenous biliary beta-glucuronidase activities were comparable in all groups, and both the hemogram and serum vitamin B12 levels were normal.. This study establishes that increased bilirubin levels in bile of patients with Crohn's disease are caused by lack of functional ileum, supporting the hypothesis that enterohepatic cycling of bilirubin occurs.

Topics: Adult; Bile; Bile Pigments; Bilirubin; Calcium; Cholelithiasis; Cholesterol; Crohn Disease; Crystallization; Enterohepatic Circulation; Female; Gallbladder; Glucuronidase; Humans; Ileal Diseases; Lipid Metabolism; Male; Middle Aged; Vitamin B 12

We determined the vitamin B12 clearance using an ultrafiltration technique and assessed whether the clearance of this vitamin B12 could be used to estimate the glomerular filtration rate (GFR). Fourteen subjects (5 had renal disease, 7 had diabetes mellitus, one had liver cirrhosis and one had cholelithiasis) divided into two groups were studied (group 1, 5 patients without vitamin B12 preloading; group 2, 9 patients with vitamin B12 preloading). Vitamin B12 clearance was significantly correlated with inulin clearance (r = 0.81, p < 0.001) in group 1; group 2 showed an even better correlation (r = 0.94, p < 0.001) with the presaturated vitamin B12 binding protein. In group 2, the mean inulin and vitamin B12 clearance values do not differ significantly (40.3 +/- 13.6 vs 48.2 +/- 17.2 ml/min), but there was a significant difference between mean inulin and creatinine clearance (40.3 +/- 13.6 vs 64.9 +/- 19.9 ml/min, p < 0.05). In conclusion, vitamin B12 clearance appears to be a more reliable method of estimating GFR than creatinine clearance.

Topics: Adult; Aged; Cholelithiasis; Creatinine; Diabetes Mellitus; Female; Glomerular Filtration Rate; Humans; Inulin; Kidney Diseases; Liver Cirrhosis; Male; Metabolic Clearance Rate; Middle Aged; Ultrafiltration; Vitamin B 12

Gastrointestinal side-effects of prolonged therapy (greater than 2 yr) with the long-acting somatostatin analog octreotide were studied in 10 acromegalic patients. After 2 yr of therapy, 6 of 10 patients had newly developed gallstones, complicated by cholangitis and jaundice in 1. Serum vitamin B-12 concentrations declined in all 10 patients [from 380 +/- 32 to 172 +/- 21 pmol/L (mean +/- SE); P = 0.023] and became abnormally low in 4. Gastric biopsy specimens, obtained during gastroscopy (9 patients), showed moderate to severe active gastritis, with damage to the superficial and deeper layers of the mucosa in 9 of 9 and focal atrophy in 7 of 9 patients. Campylobacter pylori was found in the antral mucosa in 8 of 9 patients. Although information is lacking on similar studies in untreated acromegalic patients, we suggest that patients receiving chronic octreotide therapy be closely monitored for these and possible other side-effects related to gastrointestinal actions of octreotide.

Topics: Acromegaly; Adult; Aged; Atrophy; Cholelithiasis; Epithelium; Female; Gastric Mucosa; Gastritis; Gastrointestinal Diseases; Helicobacter pylori; Humans; Male; Middle Aged; Octreotide; Vitamin B 12

Topics: Bile Acids and Salts; Celiac Disease; Cholelithiasis; Crohn Disease; Diarrhea; Humans; Ileocecal Valve; Intestinal Absorption; Intestine, Small; Mesenteric Arteries; Mesenteric Vascular Occlusion; Mesenteric Veins; Thrombosis; Vitamin B 12

Topics: Body Water; Cholelithiasis; Humans; Ileostomy; Postoperative Complications; Postoperative Period; Sodium; Urinary Calculi; 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: Aged; Cholelithiasis; Crohn Disease; Diarrhea; Female; Gastrointestinal Agents; Humans; Ileum; Ischemia; Kidney Calculi; Lignin; Malabsorption Syndromes; Male; Mesentery; Middle Aged; Postoperative Complications; Preoperative Care; Vitamin A; Vitamin B 12; Vitamin D; Vitamin K

Topics: Bile Acids and Salts; Biotransformation; Celiac Disease; Cholelithiasis; Cholestyramine Resin; Diarrhea; Humans; Hypercholesterolemia; Ileum; Intestinal Diseases; Kidney Calculi; Lipid Metabolism; Malabsorption Syndromes; Obesity; Postoperative Complications; Vitamin B 12; Water-Electrolyte Balance

Topics: Alcoholism; Cholelithiasis; Choline; Diabetes Complications; Drug Combinations; Homocysteine; Humans; Lactones; Liver Diseases; Phosphoric Acids; Vitamin B 12

Topics: Bile Acids and Salts; Celiac Disease; Cholelithiasis; Diagnosis, Differential; Diarrhea; Humans; Ileum; Intestinal Absorption; Intestinal Diseases; Lipid Metabolism; Vitamin B 12

Topics: Adult; Amino Acids; Carbon Tetrachloride Poisoning; Cholecystitis; Cholelithiasis; Female; Folic Acid; Humans; Liver Diseases; Liver Function Tests; Male; Middle Aged; Niacinamide; Vitamin B 12

Topics: Bile; Bile Acids and Salts; Biliary Tract Diseases; Cholangitis; Cholelithiasis; Cholestasis; Chromatography, Thin Layer; Escherichia coli Infections; Gallstones; Humans; Tryptophan; Vitamin B 12

Topics: Adult; Aged; Amino Acids; Cholelithiasis; Female; Folic Acid; Humans; Liver Diseases; Male; Middle Aged; Niacinamide; Nucleosides; Vitamin B 12

Topics: Adolescent; Adult; Aged; Cholecystitis; Cholelithiasis; Female; Humans; Liver Diseases; Liver Extracts; Male; Middle Aged; Nucleosides; Uridine; Vitamin B 12

Topics: Adolescent; Biliary Dyskinesia; Biomedical Research; Cholagogues and Choleretics; Cholelithiasis; Drug Therapy; Gallbladder Diseases; Geriatrics; Hepatitis A; Humans; Sorbitol; Vitamin B 12