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Schilling test: physiologic basis for and use as a diagnostic test
1Administrative Resources, E.R. Squibb & Sons, Inc., Princeton, New Jersey.
Critical Reviews in Clinical Laboratory Sciences
|January 1, 1988
Summary
The Schilling test remains essential for measuring vitamin B12 absorption in the terminal ileum, even with modern blood assays. It can also identify intrinsic factor (IF) deficiencies, crucial for accurate diagnosis.
Area of Science:
- Clinical Chemistry
- Gastroenterology
- Nutritional Science
Background:
- Binding assays for vitamin B12 in blood have largely replaced the Schilling test.
- The Schilling test measures vitamin B12 absorption directly from the terminal ileum.
- Modern assays do not assess the site of absorption or intrinsic factor function.
Purpose of the Study:
- To highlight the continued importance of the Schilling test.
- To explain the methodology and parameters for accurate Schilling test performance.
- To demonstrate the test's utility in diagnosing malabsorption and intrinsic factor deficiency.
Main Methods:
- Administration of radioactive vitamin B12 with and without intrinsic factor (IF).
- Collection of urine over 24–48 hours to measure absorbed B12.
- Analysis of urine radioactivity to determine absorption efficiency.
Main Results:
- The Schilling test is the sole method to measure vitamin B12 absorption via the terminal ileum.
- The test differentiates between ileal malabsorption and intrinsic factor deficiency.
- Accurate performance requires careful attention to administered dosage and complete urine collection.
Conclusions:
- The Schilling test remains a valuable diagnostic tool for vitamin B12 malabsorption.
- Understanding test parameters is critical for reliable results.
- It provides unique insights not available through standard blood assays.