Information de reference pour ce titreAccession Number: | 00000605-199603010-00002.
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Author: | Sumner, Anne E. MD; Chin, Margaret M. PharmD; Abrahm, Janet L. MD; Berry, Gerard T. MD; Gracely, Edward J. PhD; Allen, Robert H. MD; Stabler, Sally P. MD
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Institution: | From Philadelphia Veterans Affairs Medical Center, Medical College of Pennsylvania and Hahnemann University, Philadelphia College of Pharmacy and Science, and Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; and University of Colorado Health Sciences Center, Denver, Colorado. For current author addresses, see end of text.
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Title: | |
Source: | Annals of Internal Medicine. 124(5):469-476, March 1, 1996.
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Abstract: | Objective: To determine the prevalence of vitamin B12 deficiency in patients who have had gastric surgery.
Design: Cross-sectional study.
Setting: Philadelphia Veterans Affairs Medical Center.
Participants: 61 patients who had had gastric surgery and 107 controls.
Measurements: Serum levels of vitamin B12, folate, methylmalonic acid, and total homocysteine measured before and after treatment in participants with vitamin B12 deficiency. Vitamin B12 deficiency was defined as one of the following: 1) a serum vitamin B12 level less than 221 pmol/L and an elevated methylmalonic acid level; 2) a serum vitamin B12 level less than 221 pmol/L and an elevated total homocysteine level that decreased with vitamin B12 treatment; or 3) in patients unavailable for treatment, a serum vitamin B12 level less than 221 pmol/L, a folate level greater than 9 nmol/L, and an elevated total homocysteine level.
Results: Study patients and controls were similar in age, sex, and racial distribution. Nineteen patients (31%) and 2 controls (2%) had vitamin B12 deficiency (P less than 0.001). Twelve (63%) of the 19 vitamin B12-deficient patients had elevated total homocysteine levels. In all participants with vitamin B12 deficiency who received treatment (15 of 21), methylmalonic acid and total homocysteine levels decreased substantially, confirming the deficiency before treatment.
Conclusion: Patients who have had gastric surgery have a high prevalence of vitamin B12 deficiency. Prompt recognition and treatment of the deficiency with resultant normalization of elevated total homocysteine and methylmalonic acid levels may prevent the development of cardiovascular, hematologic, and neurologic abnormalities. Our data support both frequent screening and vitamin B12 replacement therapy in patients who have had gastric surgery and have serum vitamin B12 levels less than 221 pmol/L.
Ann Intern Med. 1996;124:469-476.
(C) 1996 American College of Physicians
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Language: | English.
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Document Type: | ARTICLES.
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Journal Subset: | Clinical Medicine.
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ISSN: | 0003-4819
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NLM Journal Code: | 0372351, 5a6
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Annotation(s) | |
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