Clinical studyOral cobalamin therapy for the treatment of patients with food-cobalamin malabsorption
Section snippets
Patient selection
Patients were recruited in the Department of Internal Medicine and Nutrition of Hautepierre Hospital, Strasbourg, France. Between January 1995 and January 1999, 75 patients were found to have a cobalamin deficiency related to food-cobalamin malabsorption 6, 7. Cobalamin deficiency was defined as a serum cobalamin level <160 pg/mL (confirmed in two samples) and a total homocysteine level >13 μM 8, 9. Food-cobalamin malabsorption was determined based on Carmel’s criteria (2) (Table 1). Patients
Results
Of 75 patients who were diagnosed with food-cobalamin malabsorption, 65 were excluded for various reasons: refusing to participate (n = 26); residing outside the immediate geographic area of Hautepierre Hospital, thus impeding adequate follow-up (n = 15); inability to follow physician’s directives (n = 14); and having concomitant life-threatening conditions (n = 10). The remaining 10 patients entered the study.
All patients were white, mean age was 78 ± 11 years, and 6 were women (Table 2). All
Discussion
The results of this prospective study indicate that patients with cobalamin deficiency due to food-cobalamin malabsorption generally benefit from oral crystalline cyanocobalamin therapy. All 10 patients had well-established food-cobalamin malabsorption 2, 14and cobalamin deficiency8, 9, 15. There has been some controversy 8, 16about whether all the patients in a previous series(2) met these criteria. In addition, 9 of the 10 patients had anemia or macrocytosis, which are late findings in
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