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Intestinal absorptive and digestive function in pernicious anemia.

C Arvantakis, C L Lyford, J Folscroft

    The American Journal of Medicine
    |December 1, 1977
    PubMed
    Summary

    Pernicious anemia patients show normal digestion but abnormal intestinal sodium and water transport. Vitamin B12 treatment did not correct this defect, indicating a persistent intestinal issue in pernicious anemia.

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    Area of Science:

    • Gastroenterology
    • Internal Medicine
    • Hematology

    Background:

    • Pernicious anemia is associated with morphologic changes in the small intestinal mucosa.
    • The functional consequences of these changes on digestion and absorption are not fully understood.

    Purpose of the Study:

    • To investigate the digestive and absorptive functions of the small intestinal mucosa in patients with pernicious anemia.
    • To determine the functional correlates of previously described morphologic changes.

    Main Methods:

    • Analysis of digestive brush border enzymes (disaccharidases, leucyl-naphthylamidase) in jejunal biopsy specimens.
    • Standard absorption tests.
    • Jejunal perfusion studies with glucose, sodium, and water.

    Main Results:

    • Digestive brush border enzyme levels were within the normal range.
    • Most absorption tests were normal, with one patient exhibiting mild steatorrhea.
    • Jejunal perfusion revealed intestinal secretion of sodium and water despite normal glucose absorption.
    • Vitamin B12 replacement therapy did not significantly improve absorption rates.

    Conclusions:

    • Patients with pernicious anemia exhibit impaired intestinal sodium and water transport.
    • This intestinal defect is a systemic manifestation of pernicious anemia.
    • The observed intestinal transport abnormality is not corrected by vitamin B12 therapy.

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