Rodríguez de Santiago E, Ferre Aracil C, García García de Paredes A, Moreira Vicente V F
Servicio de Gastroenterología, Hospital Universitario Ramón y Cajal, Madrid, España.
Servicio de Gastroenterología, Hospital Universitario Ramón y Cajal, Madrid, España.
Rev Clin Esp (Barc). 2015 Jun-Jul;215(5):276-84. doi: 10.1016/j.rce.2014.12.013. Epub 2015 Feb 11.
Pernicious anemia is currently the most common cause of vitamin B12 deficiency in Western countries. The histological lesion upon which this condition is based is autoimmune chronic atrophic gastritis. The destruction of parietal cells causes a deficiency in intrinsic factor, an essential protein for vitamin B12 absorption in the terminal ileum. Advances in the last two decades have reopened the debate on a disease that seemed to have been forgotten due to its apparent simplicity. The new role of H. pylori, the value of parietal cell antibodies and intrinsic factor antibodies, the true usefulness of serum vitamin B12 levels, the risk of adenocarcinoma and gastric carcinoids and oral vitamin B12 treatment are just some of the current issues analyzed in depth in this review.
恶性贫血是目前西方国家维生素B12缺乏最常见的原因。这种情况所基于的组织学病变是自身免疫性慢性萎缩性胃炎。壁细胞的破坏导致内因子缺乏，内因子是维生素B12在回肠末端吸收所必需的蛋白质。过去二十年的进展重新引发了关于一种似乎因其明显简单而被遗忘的疾病的争论。幽门螺杆菌的新作用、壁细胞抗体和内因子抗体的价值、血清维生素B12水平的真正效用、腺癌和胃类癌的风险以及口服维生素B12治疗只是本综述深入分析的一些当前问题。
