Effect of methionine on specific folate coenzyme pools in vitamin B 12 deficient and supplemented rats.
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In 5 normal persons, 1 patient with pernicious anemia, 5 patients with renal insufficiency in the state of compensation, and in one patient with chronic hemodialysis Schilling tests, activity of 57Co and vitamin B12 serum levels were measured. It was obvicous that activity of 57Co in serum 8 hours after oral application of 0.5 muCi 57Co-vitamin B12 showed reliable results to clear the problem of vitamin B12 malresorption. This method is easier than the Schilling test because the collection of 24-hour-urine is not necessary and an insufficiency of renal function does not influence the result.
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A 34 years old male, presenting with progressive proximal weakness, with a neurogenic pattern on needle EMG, and a family history suggestive of an autosomal recessive disorder, was found to have additional features of myeloneuropathy and a down beat nystagmus. A low serum vitamin B12 level was found, and on vitamin B12 supplementation there was a partial clinical as well as electrophysiological recovery.
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Report on a case of severe megaloblastic anemia in a vegetarian, associated with marked erythroleukemic blood findings probably caused by infections (bronchopneumonia, asthmatic bronchitis, urinary tract infection) and severe heart failure. Successful treatment of the above mentioned complications resulted in almost complete disappearance of pathologic cells from the blood even before vitamin B12 treatment was started. With this therapy complete recovery was achieved and the signs suspect for erythroleukemia in blood and bone marrow disappeared definitively. The case also fulfilled all the criteria of pernicious anemia (Schilling's test and determination of intrinsic factor were not done).