2003 paper

[Laura5]

"Patients may have advanced neuropsychiatric manifestations of cobalamin deficiency and yet not be anemic, have a normal blood smear, and even have serum cobalamin levels in the normal range."

Paper from 2003

ncbi.nlm.nih.gov/pubmed/127...

[fbirder]

I'm coming to the conclusion that gastroenterologists seem to be much more aware of the real facts about PA than either GPs or haematologists.

[Polaris]

Thanks for posting this Laura - this was an interesting extract too:

"The main causes of chronic atrophic gastritis and gastric atrophy are autoimmune due to pernicious anemia or chronic Helicobacter pylori infection. In the former condition, there is severe atrophy of the corpus (oxyntic mucosa), with the antrum being speared. In contrast, chronic atrophic gastritis consequent to H. pylori infection is a multifocal pangastritis, involving independent foci in the corpus and antrum of the stomach.

For the most part, these clinical conditions are silent; the only manifestation of both these forms of chronic atrophic gastritis is cobalamin (vitamin B(12)) deficiency."

[Leilanilea]

Laura,

Thanks for the paper. You may find this site interesting, also.

Excerpt: "However, it is important to recognise that clinical features of deficiency can manifest without anaemia and also without low serum vitamin B12 levels. In these cases treatment should still be given without delay." 4 13

cmim.org/pdf2014/funcion.ph...

Took bit time to download on my iPad but you may not have that problem.

Best Wishes,

Leilani

[Laura5 in reply to Leilanilea]

Thanks - I had already seen that one - I was just interested that they already knew this more than 10 years ago.

[Leilanilea]

Yep!