Meyers S, Schweitzer P, Gerson C D
Arch Intern Med. 1977 Feb;137(2):181-6.
A group of subjects had common features of megaloblastic anemia due to vitamin B12 deficiency, normal or high serum folate, and evidence of intestinal malabsorption. They were all former residents of the Caribbean area now living in New York City. Despite similar symptoms and diagnostic studies, two subjects were found to have pernicious anemia and three to have tropical sprue. Achlorhydria, serum anti-intrinsic factor antibody, the severity of small intestinal abnormalities, and posttherapy Schilling tests were helpful differential factors. These subjects illustrate the problems that may be encountered in differentiating tropical sprue and pernicious anemia.
一组受试者具有因维生素B12缺乏导致的巨幼细胞贫血的共同特征，血清叶酸正常或升高，并有肠道吸收不良的证据。他们都是曾居住在加勒比地区、现居住在纽约市的居民。尽管症状和诊断研究相似，但发现两名受试者患有恶性贫血，三名患有热带口炎性腹泻。胃酸缺乏、血清抗内因子抗体、小肠异常的严重程度以及治疗后希林试验是有用的鉴别因素。这些受试者说明了在鉴别热带口炎性腹泻和恶性贫血时可能遇到的问题。
