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Cobalamin Absorption

Cobalamin Absorption. Schilling Test. Pernicious Anemia Atrophy of gastric parietal cells lead to absence of gastric acid and intrinsic factor secretion Chronic Pancreatitis Deficiency of pancreatic proteases to split the cobalamin -R binder complex Achlorydia

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Cobalamin Absorption

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  1. Cobalamin Absorption

  2. Schilling Test • Pernicious Anemia • Atrophy of gastric parietal cells lead to absence of gastric acid and intrinsic factor secretion • Chronic Pancreatitis • Deficiency of pancreatic proteases to split the cobalamin-R binder complex • Achlorydia • Absence of another factor secreted with acid that is responsible for splitting cobalamin from the proteins in food • Bacterial Overgrowth syndromes • Bacterial utilization of cobalamin • Ileal dysfunction • Impaired cobalamin – intrinsic factor uptake

  3. Schilling Test

  4. BIOPSY OF SMALL-INTESTINAL MUCOSA • essential in the evaluation of a patient with documented steatorrhea or chronic diarrhea • preferred method to obtain histologic material of proximal small-intestinal mucosa • indications: • evaluation of a patient either with documented or suspected steatorrhea or with chronic diarrhea • diffuse or focal abnormalities of the small intestine defined on a small-intestinal series

  5. Biopsy Lesions and FIndings

  6. Results of Diagnostic Studies in Different Causes of Steatorrhea

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