Pernicious Anemia and Malabsorption, with Spinal Cord Degeneration Developing During Vitamin B12 Treatment

Case Studies1 March 1966Pernicious Anemia and Malabsorption, with Spinal Cord Degeneration Developing During Vitamin B12 TreatmentGEORGE J. ELLIS, M.D., RICHARD I. BREUER, M.D., EDWARD E. OWEN, M.D., JOHN LASZLO, M.D.GEORGE J. ELLIS, M.D.Search for more papers by this author, RICHARD I. BREUER, M.D.Search for more papers by this author, EDWARD E. OWEN, M.D.Search for more papers by this author, JOHN LASZLO, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-64-3-654 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptThe relationship between vitamin B12 metabolism and the diseases of B12 deficiency has been so well studied in the past few decades that it has become unusual to encounter clinical problems that fall outside the recognized patterns and appear to violate established principles. The following is a report of such a case: a patient with an inability to utilize vitamin B12 due to both small bowel malabsorption and lack of intrinsic factor, who during the course of adequate parenteral vitamin B12 administration developed clinical evidence of combined systems disease. Some possible mechanisms were explored and are discussed below.CASE REPORTPatient...References1. CASTLERHOADSLAWSONPAYNE WBCPHAGC: Etiology and treatment of sprue. Arch. Intern. Med. (Chicago) 56: 627, 1935. CrossrefGoogle Scholar2. HORRIGANHEINLE DLRW: Refractory macrocytic anemia with defect in vitamin B12 binding and with response to normal plasma. J. Lab. Clin. Med. 40: 811, 1952. Google Scholar3. MILLER A: The in vitro binding of cobalt60 labeled vitamin B12 by normal and leukemic sera. J. Clin. Invest. 37: 556, 1958. CrossrefMedlineGoogle Scholar4. KABLER JD: Rare malabsorption syndromes. Ann. Intern. Med. 52: 1221, 1960. LinkGoogle Scholar5. BENSONKOWLESSARSLEISENGER GDODMH: Adult celiac disease with emphasis upon response to the gluten-free diet. Medicine (Balt.) 43: 1, 1964. CrossrefMedlineGoogle Scholar6. HANLONDODGESIEKERTBULL DGHWRCFE: Tumors of the spinal cord: occurrence in patients with pernicious anemia and subacute combined sclerosis. JAMA 162: 707, 1956. CrossrefMedlineGoogle Scholar7. WOLTMANHECK HWFJ:Funicular degeneration of the spinal cord without pernicious anemia. Arch. Intern. Med. (Chicago) 60: 272, 1937. CrossrefGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: GEORGE J. ELLIS, M.D.; RICHARD I. BREUER, M.D.; EDWARD E. OWEN, M.D.; JOHN LASZLO, M.D.Affiliations: Durham, North CarolinaFrom the Departments of Medicine, the Duke Hospital and the Veterans Administration Hospital, Durham, N. C.Requests for reprints should be addressed to John Laszlo, M.D., Hematology Section, Veterans Administration Hospital, Durham, N. C. 27705. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited bySelective Vitamin B 12 Malabsorption in Adult Coeliac Disease: Report on Three Cases with Associated Autoimmune DiseasesMEGALOBLASTIC ANÆMIA, ACHLORHYDRIA, LOW INTRINSIC FACTOR, AND INTRINSIC-FACTOR ANTIBODIES IN THE ABSENCE OF PERNICIOUS ANÆMIACurrent Views on Tropical Sprue and a Comparison to Nontropical SprueCHRONIC BRONCHITICS IN THE SUNORAL MAINTENANCE THERAPY FOR PERNICIOUS ANÆMLAAbnormalities of Vitamin B 12 and Folic Acid Metabolism—their Influence on the Nervous SystemABSORPTION OF VITAMIN B12 1 March 1966Volume 64, Issue 3Page: 654-658KeywordsColitisFallsGastroenterology and hepatologyHospital medicineInflammatory bowel diseaseLigation assayPernicious anemiaProteinsSpinal cordSystemic diseases ePublished: 1 December 2008 Issue Published: 1 March 1966 PDF downloadLoading ...