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Low serum vitamin B12 is common in coeliac disease and is not due to autoimmune gastritis.

Abstract

OBJECTIVE

Although coeliac disease is a disorder of the proximal small bowel, associated vitamin B12 deficiency has been reported. This study aimed to assess the prevalence of B12 deficiency in a large series of coeliac patients, and to exclude the possibility that it is due to associated autoimmune gastritis.

DESIGN

Prospective routine measurement of serum B12 in coeliac patients, with investigations for pernicious anaemia/autoimmune gastritis in B12-deficient patients.

SETTING

Gastroenterology department of a large district general hospital.

INTERVENTIONS

If they were not taking vitamin B12 supplements already, patients had serum B12 measured before starting dietary gluten exclusion. Those with low levels also had gastric biopsies taken and plasma gastrin and serum gastric parietal cell and intrinsic factor antibodies measured.

MAIN OUTCOME MEASURES

Prevalence of low serum B12, and presence or absence of indicators of pernicious anaemia/autoimmune gastritis in patients with low serum B12.

RESULTS

Of 159 patients, 13 had low serum B12 at diagnosis. A further six had been receiving B12 replacement therapy for 3-37 years before diagnosis, giving an overall prevalence of 12% (19 patients). Only 2/19 patients had gastric corpus atrophy, one with intrinsic factor antibodies and the other with hypergastrinaemia. There was no relationship between low B12 and clinical characteristics.

CONCLUSIONS

Low B12 is common in coeliac disease without concurrent pernicious anaemia, and may be a presenting manifestation. B12 status should be known before folic acid replacement is started.

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  • Publisher Full Text
  • Authors+Show Affiliations

    Department of Gastroenterology, Altnagelvin Hospital, Londonderry BT47 6SB, Northern Ireland. wildickey@aol.com

    Source

    MeSH

    Adult
    Celiac Disease
    Female
    Humans
    Male
    Vitamin B 12
    Vitamin B 12 Deficiency

    Pub Type(s)

    Journal Article

    Language

    eng

    PubMed ID

    11943958

    Citation

    Dickey, William. "Low Serum Vitamin B12 Is Common in Coeliac Disease and Is Not Due to Autoimmune Gastritis." European Journal of Gastroenterology & Hepatology, vol. 14, no. 4, 2002, pp. 425-7.
    Dickey W. Low serum vitamin B12 is common in coeliac disease and is not due to autoimmune gastritis. Eur J Gastroenterol Hepatol. 2002;14(4):425-7.
    Dickey, W. (2002). Low serum vitamin B12 is common in coeliac disease and is not due to autoimmune gastritis. European Journal of Gastroenterology & Hepatology, 14(4), pp. 425-7.
    Dickey W. Low Serum Vitamin B12 Is Common in Coeliac Disease and Is Not Due to Autoimmune Gastritis. Eur J Gastroenterol Hepatol. 2002;14(4):425-7. PubMed PMID: 11943958.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Low serum vitamin B12 is common in coeliac disease and is not due to autoimmune gastritis. A1 - Dickey,William, PY - 2002/4/11/pubmed PY - 2002/5/16/medline PY - 2002/4/11/entrez SP - 425 EP - 7 JF - European journal of gastroenterology & hepatology JO - Eur J Gastroenterol Hepatol VL - 14 IS - 4 N2 - OBJECTIVE: Although coeliac disease is a disorder of the proximal small bowel, associated vitamin B12 deficiency has been reported. This study aimed to assess the prevalence of B12 deficiency in a large series of coeliac patients, and to exclude the possibility that it is due to associated autoimmune gastritis. DESIGN: Prospective routine measurement of serum B12 in coeliac patients, with investigations for pernicious anaemia/autoimmune gastritis in B12-deficient patients. SETTING: Gastroenterology department of a large district general hospital. INTERVENTIONS: If they were not taking vitamin B12 supplements already, patients had serum B12 measured before starting dietary gluten exclusion. Those with low levels also had gastric biopsies taken and plasma gastrin and serum gastric parietal cell and intrinsic factor antibodies measured. MAIN OUTCOME MEASURES: Prevalence of low serum B12, and presence or absence of indicators of pernicious anaemia/autoimmune gastritis in patients with low serum B12. RESULTS: Of 159 patients, 13 had low serum B12 at diagnosis. A further six had been receiving B12 replacement therapy for 3-37 years before diagnosis, giving an overall prevalence of 12% (19 patients). Only 2/19 patients had gastric corpus atrophy, one with intrinsic factor antibodies and the other with hypergastrinaemia. There was no relationship between low B12 and clinical characteristics. CONCLUSIONS: Low B12 is common in coeliac disease without concurrent pernicious anaemia, and may be a presenting manifestation. B12 status should be known before folic acid replacement is started. SN - 0954-691X UR - https://www.unboundmedicine.com/medline/citation/11943958/full_citation L2 - http://Insights.ovid.com/pubmed?pmid=11943958 DB - PRIME DP - Unbound Medicine ER -