Screening for Vitamin B12 Deficiency: Caveat Emptor

Editorials1 March 1996Screening for vitamin B12 Deficiency: Caveat EmptorRalph Green, MDRalph Green, MDThe Cleveland Clinic Foundation, Cleveland, OH 44195Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-124-5-199603010-00009 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Gastrectomy provides a surgical paradigm for pernicious anemia; the scalpel and autoantibodies both disrupt the crucial gastric component of cobalamin (vitamin B12) absorption. That patients are at risk for developing cobalamin deficiency after gastrectomy is therefore obvious and known. The time from surgery to the onset of cobalamin deficiency varies with the extent of parietal cell ablation and with the inventory of the stored vitamin that is conserved and stockpiled during times of plenty. In this issue, Sumner and colleagues [1] report the results of follow-up screening for cobalamin deficiency in a large series of patients who have had gastrectomy. ...References1. Sumner AE, Chin MM, Abrahm JL, Berry GT, Gracely EJ, Allen RH, et al. Elevated methylmalonic acid and total homocysteine levels show high prevalence of vitamin B12 deficiency after gastric surgery. Ann Intern Med. 1996; 124:469-76. Google Scholar2. Hines JD, Hoffbrand AV, Mollin DL. The hematologic complications following partial gastrectomy. A study of 292 patients. Am J Med. 1967; 43:555-69. Google Scholar3. Green R. Metabolite assays in cobalamin and folate deficiency. In: Wickramasinghe SN, ed. Megaloblastic Anaemias: Baillieres Clin Haematol. 1995; 8:533-66. Google Scholar4. Jacob E, Baker SJ, Herbert V. Vitamin B12-binding proteins. Physiol Rev. 1980; 60:918-60. Google Scholar5. Hakami N, Neiman PE, Canellos GP, Lazerson J. 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Google Scholar Author, Article, and Disclosure InformationAffiliations: The Cleveland Clinic Foundation, Cleveland, OH 44195Corresponding Author: Ralph Green, MD, Section of Hematology (FF4), The Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH 44195. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoElevated Methylmalonic Acid and Total Homocysteine Levels Show High Prevalence of Vitamin B12 Deficiency after Gastric Surgery Anne E. Sumner , Margaret M. Chin , Janet L. Abrahm , Gerard T. Berry , Edward J. Gracely , Robert H. Allen , and Sally P. Stabler Metrics Cited byPrevalence of low serum vitamin B12 in Mexican children and women: results from the first National Nutrition Survey (1999) as a basis for interventions and progressVitamin B12 Replasman Tedavisi; Oral? 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