Jones B P, Broomhead A F, Kwan Y L, Grace C S
Eur J Haematol. 1987 Feb;38(2):131-6. doi: 10.1111/j.1600-0609.1987.tb01150.x.
Patient records from January 1975 to December 1984 were analysed to assess the possible incidence of protein-bound vitamin B12 malabsorption. This condition is characterised by a low serum vitamin B12 level and a normal Schilling test but impaired absorption of vitamin B12 bound to protein. We found that 48 (25%) patients with a low serum cobalamin level unexplained by other causes had a normal Schilling test. Megaloblastic haemopoiesis was found in 25 of these. From this group, all 10 patients who had a test of protein-bound vitamin B12 absorption showed impaired absorption. Protein-bound vitamin B12 malabsorption may represent an early phase of pernicious anaemia when hypochlorhydria precedes intrinsic factor deficiency and should be tested for when the serum vitamin B12 level is decreased and the Schilling test is normal.
分析了1975年1月至1984年12月期间的患者记录，以评估蛋白质结合型维生素B12吸收不良的可能发生率。这种情况的特征是血清维生素B12水平低且Schilling试验正常，但与蛋白质结合的维生素B12吸收受损。我们发现，48名（25%）血清钴胺素水平低且无其他原因可解释的患者，其Schilling试验正常。其中25名患者存在巨幼细胞造血。在这组患者中，所有10名进行了蛋白质结合型维生素B12吸收试验的患者均显示吸收受损。蛋白质结合型维生素B12吸收不良可能代表恶性贫血的早期阶段，此时胃酸过少先于内因子缺乏，当血清维生素B12水平降低且Schilling试验正常时，应进行检测。
