DÄ internationalArchive17/2009Causes and Early Diagnosis of Vitamin B12 Deficiency: Gastrin Levels in Pernicious Anemia

Correspondence

Causes and Early Diagnosis of Vitamin B12 Deficiency: Gastrin Levels in Pernicious Anemia

Dtsch Arztebl Int 2009; 106(17): 290. DOI: 10.3238/arztebl.2009.0290a

Koch, C A

LNSLNS Chronic atrophic gastritis can result not only in vitamin B12 deficiency in spite of a normal serum concentration but it can also result in a raised gastrin level, which in rare cases can rise to above 1000 pg/ml (1, 2). Since such gastrin measurements are strong indicators of a gastrin producing tumor, for example, a gastrinoma, some patients without a history of ulcers or signs of a multiple endocrine dysplasia type 1 (MEN-1) disorder are subjected to comprehensive diagnostic tests for clarification (presumed diagnosis: gastrinoma?). This may be the case especially if a gastrin concentration of more than 1000 pg/ml is associated with diarrhea, which is observed in the context of autoimmune disorders. On the other hand, atrophic gastritis and pernicious anemia in patients with polyglandular syndrome of type 1 are mostly accompanied by low/normal gastrin levels, probably because of the loss of gastrin producing cells. DOI: 10.3238/arztebl.2009.0290a


Prof. Dr. med. habil. Christian A. Koch, FACP, FACE
Division of Endocrinology
University of Mississippi Medical Center
Jackson, MS 39216, USA
ckoch@medicine.umsmed.edu
1.
Koch CA: Gesundheitliche Bedeutung der Folsäurezufuhr: Vitamin-B12-Mangel trotz normalem Serumspiegel. Dtsch Arztebl 2005; 102: A-215/B-178/C-171. VOLLTEXT
2.
Lewin KJ, Dowling F, Wright JP, Taylor KB: Gastric morphology and serum gastrin levels in pernicious anaemia. Gut 1976; 17: 551–60. MEDLINE
3.
Benchimol EI, Kirsch R, Viero S, Griffiths AM: Collagenous colitis and eosinophilic gastritis in a 4-year old girl: a case report and review of the literature. Acta Paediatr 2007; 96: 1365–7. MEDLINE
4.
Herrmann W, Obeid R: Causes and early diagnosis of Vitamin B12 deficiency [Ursachen und frühzeitige Diagnostik von Vitamin B12-Mangel]. Dtsch Arztebl Int 2008; 105(40): 680–5. VOLLTEXT
1. Koch CA: Gesundheitliche Bedeutung der Folsäurezufuhr: Vitamin-B12-Mangel trotz normalem Serumspiegel. Dtsch Arztebl 2005; 102: A-215/B-178/C-171. VOLLTEXT
2. Lewin KJ, Dowling F, Wright JP, Taylor KB: Gastric morphology and serum gastrin levels in pernicious anaemia. Gut 1976; 17: 551–60. MEDLINE
3.Benchimol EI, Kirsch R, Viero S, Griffiths AM: Collagenous colitis and eosinophilic gastritis in a 4-year old girl: a case report and review of the literature. Acta Paediatr 2007; 96: 1365–7. MEDLINE
4. Herrmann W, Obeid R: Causes and early diagnosis of Vitamin B12 deficiency [Ursachen und frühzeitige Diagnostik von Vitamin B12-Mangel]. Dtsch Arztebl Int 2008; 105(40): 680–5. VOLLTEXT