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Malabsorption of food cobalamin
1University of Southern California School of Medicine, Los Angeles 90033, USA.
Bailliere'S Clinical Haematology
|September 1, 1995
Summary
Food-cobalamin malabsorption prevents vitamin B12 release from food, leading to deficiency. This condition is often insidious and requires specific diagnostic tests beyond the standard Schilling test for accurate identification and management.
Area of Science:
- Gastroenterology
- Nutritional Science
- Internal Medicine
Background:
- Food-cobalamin malabsorption involves impaired vitamin B12 release from food proteins.
- Classical tests like the Schilling test fail to detect this specific malabsorption.
- Gastric acid and pepsin are crucial for releasing cobalamin from food.
Purpose of the Study:
- To define food-cobalamin malabsorption and differentiate it from other cobalamin absorption defects.
- To highlight the diagnostic challenges posed by this condition.
- To discuss the clinical spectrum and implications of food-cobalamin malabsorption.
Main Methods:
- Utilized specialized tests employing cobalamin bound to food matrices (e.g., eggs, chicken serum).
- Compared results from food-cobalamin absorption tests with standard Schilling test results.
- Analyzed clinical data to understand the presentation and progression of the disorder.
Main Results:
- Food-cobalamin malabsorption is characterized by normal absorption of free cobalamin but impaired absorption of food-bound cobalamin.
- The condition can stem from gastric defects affecting acid and pepsin secretion.
- Clinical presentation ranges from normal cobalamin status to severe deficiency, mimicking pernicious anemia.
Conclusions:
- Food-cobalamin malabsorption may be the most common cause of subtle cobalamin deficiency.
- Its insidious nature and normal Schilling test results can delay diagnosis.
- Wider clinical consideration for its identification and treatment is warranted.