Does Malabsorption of Vitamin B12 Occur in Chronic Pancreatitis ?

Henderson, J.; Warwick, Rita; Simpson, John; Shearman, D. J. C.

doi:10.1016/s0140-6736(72)91684-4

Cited by 46 publications

(9 citation statements)

References 19 publications

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“…In four of the five patients where a meal poor in vitamin B12 had been added to the radioactive test dose, an absorption-enhancing effect was found, although not the same extent as described by Henderson et al in patients with alcohol-induced chronic pancreatitis and exocrine pancreatic insufficiency [4]. These authors believed that this surprising phenomenon could be explained by the stimulating effect of diet on the residual function of the exocrine pancreas which was still able to restore the vitamin B12 absorption to normal.…”

Section: Discussionsupporting

confidence: 58%

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Vitamin B12 absorption and exocrine pancreatic insufficiency in childhood

et al. 1981

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The absorption of vitamin B12, labelled with radioactive 58Co, was measured in 19 patients with cystic fibrosis and one child with the Shwachman-Diamond syndrome using the whole body counting technique. We found vitamin B12 absorption reduced to 7.97 on average, compared to 59.2% for the control group. The low vitamin B12 absorption correlated well with the reduced fat retention coefficients. After adding 0.212 pancreatin to the radioactive vitamin B12 test dose, the absorption quotas improved in all cases, the average being 61%. A meal poor in vitamin B12 tended to increase the absorption of the radioactive test dose to 23% on average. As yet there is no satisfactory explanation for the effect of the diet on the absorption of vitamin B12 in exocrine pancreatic insufficiency. This could be the reason why the malabsorption of vitamin B12 in patients with EPI can go unnoticed for many years and could possibly explain why vitamin B12 malabsorption in exocrine pancreatic insufficiency does not cause symptoms and signs of vitamin B12 deficiency for many years.

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Section: Discussionsupporting

confidence: 58%

“…Absorption could be improved with herterologous pancreatic enzymes or with sodium bicarbonate. Unlike Henderson et al [4], they did not find a meal poor in vitamin B12 enhanced absorption.…”

Section: Introductionmentioning

confidence: 58%

Vitamin B12 absorption and exocrine pancreatic insufficiency in childhood

et al. 1981

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“…Vitamin B12 malabsorption occurs in some patients with chronic pancreatic exocrine insufficiency (1)(2)(3) and in rats subjected to partial pancreatectomy (4). Although hog pancreatic extract corrects the absorptive defect in both humans and animals (1,2,4), the precise constituent in the pancreatic extract responsible for the enhancement of vitamin B12 absorption has not been determined.…”

Section: Introductionmentioning

confidence: 99%

Trypsin-Like Nature of the Pancreatic Factor That Corrects Vitamin B12 Malabsorption Associated with Pancreatic Dysfunction

Toskes¹,

Deren²,

Conrad³

1973

J. Clin. Invest.

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A B S T R A C T Hog pancreas was subfractionated and assessed for its ability to correct vitamin B12 malabsorption in patients with pancreatic dysfunction and in rats with partial pancreatic extirpation. The constituent obtained from the pancreas that increased vitamin B12 absorption in both humans and rats was soluble at 50,000 g, heat labile, acid stable, and approximately 20,000-25,0000 in molecular weight. The active subfractions contained tryptic and chymotryptic but no amylase or lipase activity. Thrice-crystallized trypsin corrected the vitamin B12 malabsorption in both patients with pancreatic insufficiency and in rats with subtotal pancreatectomy. These data indicate that pancreatic proteolytic enzymes-in particular, trypsin-are necessary for optimal vitamin Bn absorption.

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“…Although pernicious anemia (PA) is the most common cause of vitamin B12 (Bi2) malabsorption, some patients with chronic pancreatic insufficiency have been noted to have impaired B12 absorption since the first report of McIntyre et al [2,[8][9][10]14,18,21].…”

mentioning

confidence: 99%

“…All other previous studies in human subjects examined BJ2 absorption using Sc h il l in g 's [16] urinary excretion technique except the study of H enderson et at. [8],…”

mentioning

confidence: 99%

Effect of Pancreatin on Vitamin B<sub>12</sub> Malabsorption in Patients with Total Pancreatectomy

Morishita¹,

Fujii²,

Yamamoto³

et al. 1974

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Studies on vitamin B₁₂ absorption were performed in three patients with total pancreatectomy, three with partial pancreatectomy and a single case of pernicious anemia by a whole body counting method. All three subjects with total pancreatectomy showed _B12 malabsorption. In two out of the three patients, _B12 absorption was improved by administration of pancreatic extract, pancreatin. Another patient showed the most improved absorption when normal human gastric juice in an amount of 20 ml was administered with pancreatin because of the lack of intrinsic factor in the gastric juice. The improvable effect of pancreatin on _B12 absorption was markedly reduced by heating at 100°C for 10 min. The pancreatin, per se, had no intrinsic factor activity. Two patients with partial pancreatectomy showed normal or intermediate _B12 absorption and a slight depression of _B12 absorption by administration of pancreatin. The contamination by vitamin _B12 in pancreatin might have been responsible for reduction of _B12 absorption. The data obtained indicated that the normal secretory functions of both the pancreas and gastric intrinsic factor were necessary for an optimal _B12 absorption. The possible mechanisms to account for the beneficial effects of pancreatin on vitamin _B12 absorption are discussed.

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Does Malabsorption of Vitamin B12 Occur in Chronic Pancreatitis ?

Cited by 46 publications

References 19 publications

Vitamin B12 absorption and exocrine pancreatic insufficiency in childhood

Vitamin B12 absorption and exocrine pancreatic insufficiency in childhood

Trypsin-Like Nature of the Pancreatic Factor That Corrects Vitamin B12 Malabsorption Associated with Pancreatic Dysfunction

Effect of Pancreatin on Vitamin B<sub>12</sub> Malabsorption in Patients with Total Pancreatectomy

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