Marks J, Shuster S
Br Med J. 1970 Sep 12;3(5723):618-21. doi: 10.1136/bmj.3.5723.618.
The excretion in the urine of (58)Co after an oral dose of (58)Co vitamin B(12) given together with intrinsic factor has been found to be reduced in a number of patients with psoriasis, eczema, and other less common dermatoses. There is a correlation between the abnormality and the extent of the rash. A reduced glomerular filtration rate was found in a few of the patients in whom it was measured, and this must have been responsible, at least in part, for the reduced excretion of vitamin B(12) in these patients, but abnormal vitamin B(12) excretion also occurred in the absence of impaired renal function. Our evidence is insufficient to show whether malabsorption or increased tissue utilization of vitamin B(12) was the explanation in other cases. Certainly a number of patients had steatorrhoea, and in these it is most likely that malabsorption was the major factor. In patients without steatorrhoea a lone malabsorption of vitamin B(12) cannot be excluded. A decreased serum concentration of vitamin B(12) was found in only one of the patients.
给一些患有牛皮癣、湿疹及其他不太常见皮肤病的患者口服（58）钴维生素B12并同时给予内因子后，发现他们尿液中（58）钴的排泄量减少。这种异常与皮疹的范围之间存在相关性。在少数接受测量的患者中发现肾小球滤过率降低，这至少在一定程度上必定是这些患者维生素B12排泄减少的原因，但在肾功能未受损的情况下也出现了维生素B12排泄异常。我们的证据不足以表明在其他情况下是维生素B12吸收不良还是组织对其利用率增加所致。确实有一些患者出现脂肪泻，在这些患者中，吸收不良很可能是主要因素。在没有脂肪泻的患者中，不能排除单纯的维生素B12吸收不良。仅在一名患者中发现血清维生素B12浓度降低。
