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Atrophic Gastritis and Vitamin B 12 Deficiency
Author(s) -
Supiano Mark A.
Publication year - 1987
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/j.1532-5415.1987.tb04684.x
Subject(s) - atrophic gastritis , vitamin b12 , medicine , methylmalonic acid , malabsorption , macrocytosis , pernicious anemia , gastroenterology , gastritis , intrinsic factor , anemia , stomach
To the Editor-The recent paper by Krasinski et al.' describing the utility of serum pepsinogen I and pepsinogen I1 levels to identify fundic atrophic gastritis in the elderly includes some interesting findings. I believe their conclusion relating atrophic gastritis to vitamin BI2 deficiency requires clarification. The data clearly show an increase in the prevalence of low serum vitamin BI2 levels with increasing severity of atrophic gastritis as defined by the authors. However, one may not equate vitamin BI2 deficiency with a low serum vitamin BIZ level given the high false-positive rate of the serum BIZ Thus, further assessment of the 17 subjects with low vitamin BI2 levels with respect to: 1) hematologic and neurologic parameters (eg, anemia, macrocytosis, or proprioceptive defects); 2) the presence of BI2 malabsorption (Schilling's test); and 3) an indirect measure of "tissue" level of BIZ (urine or serum methylmalonic acid determinat i ~ n ) ~ , ~ , ~ would be required before a diagnosis of vitamin BI2 deficiency could be supported. If this data could be provided for these subjects, the authors' conclusion that atrophic gastritis, as defined by their method, is associated with vitamin BI2 deficiency (as well as with low serum vitamin BI2 levels) would be valid. 1.