Giardiasis: haematological status and the absorption of vitamin B₁₂ and folic acid

Abstract

The haematological status, as well as the fractional absorptions of folic acid (FAFol) and vitamin B12 (FAB12) were studied in 29 children aged 0.7-13.5 years (mean 3.3 years) with chronic diarrhoea due to giardiasis. Small intestinal biopsies revealed mucosal damage in 20 children; the biopsies of the remaining nine children were normal. At the initial investigation the FAFol and FAB12 values were below normal in approximately one-sixth and one-third of patients, respectively. Bacterial overgrowth of the small intestinal tract did not seem to play a role in FAB12 malabsorption. About one-fifth of patients had mild anaemia. None of the patients showed FAB12 insufficiency and only one patient suffered from folate depletion. At follow-up, FAFol, FAB12, haemoglobin and Erc-folate concentrations increased significantly while P-B12 and P-folate remained unchanged. Iron status, as well as dietary intake of iron, appeared insufficient prior to, as well as after treatment. Serum iron, transferrin saturation and haemoglobin concentrations were lower in patients who had acquired the disease abroad or suffered from persistent diarrhoea.

The Properties of Vitamin B12 Deficiency in the Patients of an Outpatient Clinic

“…Gastric bypass surgery, gluten enteropathy, some drugs and Helicobacter pylori gastritis are common causes of vitamin B12 malabsorption 1,5,16,[21][22][23][24][25][26][27][28][29] Although only 85 patients underwent endoscopic evaluation in our study, Helicobacter pylori positive gastritis rate was found quite frequently (77.6%), which is concordant with the findings of a previously published paper. 25 In that article, authors noted that Helicobacter pylori IgG values were not statistically different between the patients with low and normal vitamin B12 levels, although they were slightly higher in low B12 group.…”

“…The most common reason accounting for deficiency is inadequate intake. [1][2][3][4][5]9,11,12,15,[20][21][22][23][24][25][26][27][28][29] Our study also displays the importance of inadequate intake of Vit B12-rich food items in the occurence of serum Vit B12 deficiency. As well known, dietary deficiency is most commonly observed among strict vegetarians, alcoholics and elderly.…”

Vitamin B12and Folic Acid in Children with Intestinal Parasitic Infection

“…Low vitamin B 12 levels have been seen in cases of infection with Giardia lamblia, Plasmodium falciparum, Diphyllobothrium latum and Strongylloides stercolaris [20,21]. Hjelt et al [22], in 1992, noted an abnormal fractional absorption of vitamin B 12 and folic acid in children with chronic diarrhea due to giardiasis. In the initial investigation, these values were below normal in one-third and one-sixth of patients, respectively.…”

Homocysteine and methylmalonic acid levels in pregnant Nepali women. Should cobalamin supplementation be considered?

“…Cobalamin deficiency is reported to be common also in India (Jathar et al, 1970;Kumar et al, 1989). In addition, malabsorption due to intestinal infections (Casterline et al, 1997;Hjelt et al, 1992) and the increased requirements during pregnancy (Allen, 1994) may represent possible causes of cobalamin deficiency. In many cases, it is most likely a combination of these factors.…”