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Evolution of Protein-Bound Cobalamin Malabsorption-Reply

Evolution of Protein-Bound Cobalamin Malabsorption-Reply Abstract In Reply. —With their additional case, King and Toskes raise several germane speculations and questions. Clearly, we need to understand better the process that is measured by testing protein-bound cobalamin absorption, whether by using cobalamin incorporated into eggs and other foods as developed by Doscherholmen et al,1,2 or cobalamin bound to chicken serum binders as used by King and Toskes. We also need to establish the mechanism, importance, and natural history of such malabsorption to know how to respond to abnormal results.Two clinical issues seem paramount. One is how often this subtle abnormality of absorption evolves into overt pernicious anemia accompanied by an abnormal Schilling test result. So far, King and Toskes and I have each been dealing with highly selected cases. Nevertheless, these observations suggest that systematic prospective study may well disclose such a progression to be common, perhaps even common enough to call for prophylactic treatment. References 1. Doscherholmen A, McMahon J, Ripley D: Inhibitory effects of eggs on vitamin B12 absorption: Description of a simple ovalbumin 57Co-vitamin B12 absorption test. Br J Haematol 1976;33:261-272.Crossref 2. Doscherholmen A, McMahon J, Ripley D: Vitamin B12 assimilation from chicken meat. Am J Clin Nutr 1978;31:825-830. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Evolution of Protein-Bound Cobalamin Malabsorption-Reply

Archives of Internal Medicine , Volume 143 (11) – Nov 1, 1983

Evolution of Protein-Bound Cobalamin Malabsorption-Reply

Abstract

Abstract In Reply. —With their additional case, King and Toskes raise several germane speculations and questions. Clearly, we need to understand better the process that is measured by testing protein-bound cobalamin absorption, whether by using cobalamin incorporated into eggs and other foods as developed by Doscherholmen et al,1,2 or cobalamin bound to chicken serum binders as used by King and Toskes. We also need to establish the mechanism, importance, and natural history of such...
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Publisher
American Medical Association
Copyright
Copyright © 1983 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1983.00350110213055
Publisher site
See Article on Publisher Site

Abstract

Abstract In Reply. —With their additional case, King and Toskes raise several germane speculations and questions. Clearly, we need to understand better the process that is measured by testing protein-bound cobalamin absorption, whether by using cobalamin incorporated into eggs and other foods as developed by Doscherholmen et al,1,2 or cobalamin bound to chicken serum binders as used by King and Toskes. We also need to establish the mechanism, importance, and natural history of such malabsorption to know how to respond to abnormal results.Two clinical issues seem paramount. One is how often this subtle abnormality of absorption evolves into overt pernicious anemia accompanied by an abnormal Schilling test result. So far, King and Toskes and I have each been dealing with highly selected cases. Nevertheless, these observations suggest that systematic prospective study may well disclose such a progression to be common, perhaps even common enough to call for prophylactic treatment. References 1. Doscherholmen A, McMahon J, Ripley D: Inhibitory effects of eggs on vitamin B12 absorption: Description of a simple ovalbumin 57Co-vitamin B12 absorption test. Br J Haematol 1976;33:261-272.Crossref 2. Doscherholmen A, McMahon J, Ripley D: Vitamin B12 assimilation from chicken meat. Am J Clin Nutr 1978;31:825-830.

Journal

Archives of Internal MedicineAmerican Medical Association

Published: Nov 1, 1983

References