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Coexistent Pernicious Anemia and Malabsorption in Four Patients: Including One Whose Malabsorption Disappeared with Vitamin B12 Therapy

EUGENE A. BRODY, M.D.; SOLOMON ESTREN, M.D., F.A.C.P.; and VICTOR HERBERT, M.D.
Ann Intern Med. 1966;64(6):1246-1251. doi:10.7326/0003-4819-64-6-1246
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Evaluation of patients with megaloblastic anemia due to vitamin B12 deficiency includes absorption studies using radioactive labeled vitamin B12 and intrinsic factor. These studies are performed not only to prove or disprove a vitamin B12 absorptive defect but also to distinguish between gastric intrinsic factor lack and small bowel dysfunction as etiologies for this absorptive defect. Vitamin B12 deficiency is generally regarded as due to either one of these two factors. This report presents three patients in whom pernicious anemia and small bowel lesions associated with small intestinal malabsorption of vitamin B12 coexisted, and a fourth in whom pernicious anemia

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