Blood, 1961, Vol. 18, No. 1, pp. 48-60.
© 1961 American Society of Hematology, Inc.
Studies of a Patient with Selective Deficiency
in Absorption of Vitamin B12
E. COLLE 1,
L. GREENBERG 1, and
WILLIAM KRIVIT 1
1 Department of Pediatrics, University of Minnesota, Minneapolis, Minn.
A 2 year old girl with a megaloblastic anemia secondary to B12 deficiency
was presented. The mechanism appeared to be a specific inability to absorb
vitamin B12 from the small bowel in the absence of any other functional disability.
Evidence of absorption of vitamin B12 was obtained when intestinal juice
from a normal patient was administered with the test dose of vitamin B12. This
evidence consisted of (1) an increased urinary excretion of the test dose
(positive Schilling test), (2) a decreased fecal excretion of the labelled B12
and (3) the presence of significant counts over the liver (positive Glass test).
A generalized malabsorption can only be totally and absolutely disproven by
testing over many years. It is considered more probable, however, that this
patient lacks an intestinal factor required for the absorption of vitamin B12.
Submitted on January 30, 1961
Accepted on April 25, 1961
