Response of lingual manifestation of pernicious anemia to pteroylglutamic acid and vitamin B12

1949 ◽  
Vol 7 (2) ◽  
pp. 256-257
Author(s):  
James F. Schieve ◽  
R.W. Rundles
Blood ◽  
1950 ◽  
Vol 5 (11) ◽  
pp. 1009-1016 ◽  
Author(s):  
RONALD H. GIRDWOOD

Abstract The gastric juice and small intestinal secretions of three cases of untreated pernicious anemia and two control patients obtained during a period of fasting contained only very small amounts of pteroylglutamic acid or of factors for the growth of L. leichmannii, which include vitamin B12; there was no evidence of a consistent increase or decrease of these factors along the intestine. Both pteroylglutamic acid and vitamin B12 appear to be synthesized in relatively large amounts in the large intestine; in a patient with pernicious anemia, the daily output in the stools may be about 5 micrograms of vitamin B12 and 0.5 mg. of pteroylglutamic acid. Similar quantities may be present in patients not suffering from this disorder.


Blood ◽  
1953 ◽  
Vol 8 (5) ◽  
pp. 469-485 ◽  
Author(s):  
RONALD H. GIRDWOOD

Abstract 1. When the sera of pernicious anemia patients or controls were heated at 100 C. for 30 minutes, they developed the ability to support the growth of L. leichmannii by virtue of some substance other than vitamin B12. It seemed likely, however, that following the administration of the vitamin, such heating also liberated free B12 in the serum from a combined form. 2. The L. leichmannii assay did not appear to be satisfactory for showing possible difference in the levels of vitamin B12 in the urines or sera of pernicious anemia patients and controls. 3. Parenterally administered vitamin B12 did not cause any measurable rise in the serum level of folic acid or citrovorum factor in pernicious anemia patients or controls. 4. The synthetic folic acid conjugates pteroyldiglutamic acid and pteroyltriglutamic acid appeared in the sera and urines of pernicious anemia patients as pteroylglutamic acid or some related substance with folic acid activity for S. faecalis. 5. Orally administered citrovorum factor appeared to be largely converted by the gastric juice to folic acid if free hydrochloric acid was present. When administered parenterally, however, citrovorum factor was excreted in the urine largely unchanged.


2017 ◽  
Vol 6 (12) ◽  
pp. 5562
Author(s):  
Tiana Mary Alexander ◽  
Vineeta Pande ◽  
Sharad Agarkhedkar ◽  
Dnyaneshwar Upase

Megaloblastic anemia is a common feature between 6 months – 2 years and rarely occurs after 5 years of age, especially in a child consuming non-vegetarian diet. B12 deficiency may occur after 5 years of age because of chronic diarrhea, malabsorption syndrome, or intestinal surgical causes. Pernicious anemia causes B12 deficiency, but nutritional B12 deficiency with subacute combined degeneration causing ataxia is rare.


PEDIATRICS ◽  
1949 ◽  
Vol 4 (6) ◽  
pp. 723-729
Author(s):  
CALVIN W. WOODRUFF ◽  
HOWARD W. RIPY ◽  
J. CYRIL PETERSON ◽  
WILLIAM J. DARBY

Two cases of megaloblastic anemia in infancy have improved following treatment with vitamin B12. A third case failed to respond to this factor but subsequently responded to pteroylglutamic acid (folic acid). It is suggested that megaloblastic anemia may be a syndrome which embraces more than one entity.


1950 ◽  
Vol 17 (3) ◽  
pp. 166-168 ◽  
Author(s):  
D. W. BORTZ ◽  
J. D. BATTLE

Blood ◽  
1968 ◽  
Vol 31 (1) ◽  
pp. 55-65 ◽  
Author(s):  
SIGMUND BENHAM KAHN ◽  
ISADORE BRODSKY ◽  
Sandra A. Fein

Abstract An interrelationship between vitamin C and vitamin B12 was studied in three patients with vitamin B12 deficiency associated with pernicious anemia. Subnormal plasma ascorbate concentrations were found prior to therapy confirming previous observations. Following vitamin B12 administration and utilizing methylmalonate (MMA) excretion as a biochemical index of vitamin B12 deficiency, low plasma ascorbate concentrations persisted until MMA excretion was abolished. In two patients, RBC vitamin B12 activity was also serially measured in order to evaluate its sensitivity as an index of vitamin B12 stores when compared to MMA excretion. The data demonstrate that in these two vitamin B12-deficient patients undergoing slow repletion therapy, RBC vitamin B12 activity returns to normal before MMA excretion is abolished. Whether continued MMA excretion in these patients indicates a greater sensitivity of MMA excretion as an index of deficiency of vitamin B12 stores than does RBC vitamin B12 activity remains to be answered by future work.


Blood ◽  
1951 ◽  
Vol 6 (10) ◽  
pp. 867-891 ◽  
Author(s):  
G. E. CARTWRIGHT ◽  
BETTY TATTING ◽  
JEAN ROBINSON ◽  
N. M. FELLOWS ◽  
F. D. GUNN ◽  
...  

Abstract In an effort to produce a deficiency of vitamin B12 a total of 70 pigs were fed a purified diet containing soybean alpha protein in place of casein. One group of animals was started on the diet at 2 to 7 days of age. A second group began at 21 to 28 days of age. Methionine, iodinate casein, desiccated thyroid and pteroylglutamic acid were added to the diet of certain animals and! omitted from the diet of other pigs. In addition, 9 pigs were gastrectomized. Forty-three of the animals survived for a sufficiently long period of time for adequate evaluation of the results of the experiment. Severe liver damage was observed in 24 of the 25 animals autopsied. The only animal not showing liver damage received vitamin B12 from the beginning of the experiment. Necrosis of the liver cells, fatty infiltration, or both, occurred in the presence of a high fat diet containing apparently adequate amounts of protein, choline, vitamin E and methionine. These pathologic changes were apparently prevented but not reversed by the administration of vitamin B12. Growth of the animals on the above diets without added vitamin B12 was retarded as compared with the growth of animals on the same diet supplemented with this vitamin. The administration of vitamin B12 to the deficient animals resulted in rapid growth. Of the 39 animals not receiving vitamin B12 13 failed to develop anemia, 16 developed a mild anemia and in 10 a moderately severe anemia was present. When present the anemia was normocytic and in 24 pigs was accompanied by a moderately severe neutropenia. Differential cell counts on the sternal marrow were normal except for a slight increase in the proportion of normoblasts. These hematologic alterations were neither consistently or completely corrected by the administration of vitamin B12 in spite of the fact that definite and sometimes marked reticulocyte increases followed. When methionine deficiency was associated with vitamin B12 deficiency, anemia appeared to be more severe. The administration of aureomycin, an "animal protein factor," did not stimulate growth and failed to induce a hemopoietic response. There was no macrocytic anemia, the bone marrow was not megaloblastic, and neurologic disturbances or morphologic alterations in the neutrophils were not observed. These results are in contrast to those obtained in pigs with an experimentally produced deficiency of pteroylglutamic acid. Such animals develop macrocytic anemia, leukopenia and a macronormoblastic type of bone marrow. It is not possible to give with any assurance the reason why megaloblastic anemia was not produced in the "B12-deficient" animals. This may have been due to the fact that (1) the deficiency was not sufficiently severe to result in such a change in the hemopoietic system; or (2) because pteroylglutamic acid prevents the development of megaloblastic anemia even in the absence of vitamin B12.


2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
G. F. Cittolin-Santos ◽  
S. Khalil ◽  
J. K. Bakos ◽  
K. Baker

A 28-year-old Caucasian male with Hashimoto’s disease and vitiligo presented with two weeks of dizziness on exertion following pharyngitis which was treated with prednisone 40 mg by mouth once a day for five days. Initial workup revealed anemia, elevated lactate dehydrogenase (LDH), and low haptoglobin. He underwent workup for causes of hemolytic anemia which was remarkable for a peripheral blood smear with hypersegmented neutrophils and low vitamin B12 levels concerning for pernicious anemia. Parietal cell and intrinsic factor antibodies were negative, and he then underwent an esophagogastroduodenoscopy with biopsy. The biopsy was negative for Helicobacter pylori, and the immunohistochemical stains were suggestive of chronic atrophic gastritis. He was started on vitamin B12 1,000 mcg intramuscular injections daily. His hemoglobin, LDH, and haptoglobin normalized. Given the absence of the parietal cell antibody and intrinsic factor antibody, this is a rare case of seronegative pernicious anemia.


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