Vitamin B12 deficiency and gastric histopathology in older patients

K. R. Dholakia, Thiruvinvamalai S. Dharmarajan, D. Yadav, S. Oiseth, E. P. Norkus, C. S. Pitchumoni

Research output: Contribution to journalArticle

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Abstract

Aim: To compare upper gastric endoscopic and histopathologic findings in older adults in the presence and absence of B12 deficiency. Methods: A prospective analysis of upper gastric endoscopic and gastric histopathologic findings from 30 newly identified B12-deficient patients (11 males, 19 females) and 16 controls with normal B12 status (6 males, 10 females) was performed. For all subjects, the indication for upper endoscopy and gastric biopsy were unrelated to B12 status. A single pathologist, blinded to B12 status, processed and interpreted the biopsy samples. Endoscopic and histopathologic findings were correlated with age, gender, hematocrit (Hct), MCV and B12 status. Results: The B12-deficient group had significantly lower mean serum B12 levels compared to the controls (P<0.00005) while their mean Hct, MCV and serum albumin levels were similar. Iron deficiency (ferritin-based) was present in 21% of B12-deficient patients and intrinsic factor antibodies were present in 29% (5/17) of B12-deficient patients. The endoscopic findings revealed significantly different rates of gastritis and atrophy between the B12-deficient and control groups (P=0.017). B12-deficient patients had significantly less superficial gastritis (62% vs 94%) and significantly more atrophic gastritis (28% vs 0%) as compared to the controls (P=0.039). Intestinal metaplasia was similar in both groups. Helicobacter pylori infection rates were similar in the B12-deficient patients and controls (40% vs 31%). Conclusion: Significantly different endoscopic findings and types of gastritis could often be observed in the presence and absence of B12 deficiency. Atrophy, based on endoscopy, and atrophic gastritis, based on histopathology, suggest the presence of B12 deficiency. Gastric histopathology is not influenced by the age, gender, Hct or MCV of the patients.

Original languageEnglish (US)
Pages (from-to)7078-7083
Number of pages6
JournalWorld Journal of Gastroenterology
Volume11
Issue number45
StatePublished - Dec 7 2005
Externally publishedYes

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Vitamin B 12 Deficiency
Stomach
Gastritis
Hematocrit
Atrophic Gastritis
Endoscopy
Atrophy
Biopsy
Intrinsic Factor
Metaplasia
Helicobacter Infections
Ferritins
Helicobacter pylori
Serum Albumin
Iron
Control Groups
Antibodies
Serum

Keywords

  • Gastric histopathology
  • Older adults
  • Vitamin B12 deficiency

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Dholakia, K. R., Dharmarajan, T. S., Yadav, D., Oiseth, S., Norkus, E. P., & Pitchumoni, C. S. (2005). Vitamin B12 deficiency and gastric histopathology in older patients. World Journal of Gastroenterology, 11(45), 7078-7083.

Vitamin B12 deficiency and gastric histopathology in older patients. / Dholakia, K. R.; Dharmarajan, Thiruvinvamalai S.; Yadav, D.; Oiseth, S.; Norkus, E. P.; Pitchumoni, C. S.

In: World Journal of Gastroenterology, Vol. 11, No. 45, 07.12.2005, p. 7078-7083.

Research output: Contribution to journalArticle

Dholakia, KR, Dharmarajan, TS, Yadav, D, Oiseth, S, Norkus, EP & Pitchumoni, CS 2005, 'Vitamin B12 deficiency and gastric histopathology in older patients', World Journal of Gastroenterology, vol. 11, no. 45, pp. 7078-7083.
Dholakia KR, Dharmarajan TS, Yadav D, Oiseth S, Norkus EP, Pitchumoni CS. Vitamin B12 deficiency and gastric histopathology in older patients. World Journal of Gastroenterology. 2005 Dec 7;11(45):7078-7083.
Dholakia, K. R. ; Dharmarajan, Thiruvinvamalai S. ; Yadav, D. ; Oiseth, S. ; Norkus, E. P. ; Pitchumoni, C. S. / Vitamin B12 deficiency and gastric histopathology in older patients. In: World Journal of Gastroenterology. 2005 ; Vol. 11, No. 45. pp. 7078-7083.
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AU - Dharmarajan, Thiruvinvamalai S.

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AU - Norkus, E. P.

AU - Pitchumoni, C. S.

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N2 - Aim: To compare upper gastric endoscopic and histopathologic findings in older adults in the presence and absence of B12 deficiency. Methods: A prospective analysis of upper gastric endoscopic and gastric histopathologic findings from 30 newly identified B12-deficient patients (11 males, 19 females) and 16 controls with normal B12 status (6 males, 10 females) was performed. For all subjects, the indication for upper endoscopy and gastric biopsy were unrelated to B12 status. A single pathologist, blinded to B12 status, processed and interpreted the biopsy samples. Endoscopic and histopathologic findings were correlated with age, gender, hematocrit (Hct), MCV and B12 status. Results: The B12-deficient group had significantly lower mean serum B12 levels compared to the controls (P<0.00005) while their mean Hct, MCV and serum albumin levels were similar. Iron deficiency (ferritin-based) was present in 21% of B12-deficient patients and intrinsic factor antibodies were present in 29% (5/17) of B12-deficient patients. The endoscopic findings revealed significantly different rates of gastritis and atrophy between the B12-deficient and control groups (P=0.017). B12-deficient patients had significantly less superficial gastritis (62% vs 94%) and significantly more atrophic gastritis (28% vs 0%) as compared to the controls (P=0.039). Intestinal metaplasia was similar in both groups. Helicobacter pylori infection rates were similar in the B12-deficient patients and controls (40% vs 31%). Conclusion: Significantly different endoscopic findings and types of gastritis could often be observed in the presence and absence of B12 deficiency. Atrophy, based on endoscopy, and atrophic gastritis, based on histopathology, suggest the presence of B12 deficiency. Gastric histopathology is not influenced by the age, gender, Hct or MCV of the patients.

AB - Aim: To compare upper gastric endoscopic and histopathologic findings in older adults in the presence and absence of B12 deficiency. Methods: A prospective analysis of upper gastric endoscopic and gastric histopathologic findings from 30 newly identified B12-deficient patients (11 males, 19 females) and 16 controls with normal B12 status (6 males, 10 females) was performed. For all subjects, the indication for upper endoscopy and gastric biopsy were unrelated to B12 status. A single pathologist, blinded to B12 status, processed and interpreted the biopsy samples. Endoscopic and histopathologic findings were correlated with age, gender, hematocrit (Hct), MCV and B12 status. Results: The B12-deficient group had significantly lower mean serum B12 levels compared to the controls (P<0.00005) while their mean Hct, MCV and serum albumin levels were similar. Iron deficiency (ferritin-based) was present in 21% of B12-deficient patients and intrinsic factor antibodies were present in 29% (5/17) of B12-deficient patients. The endoscopic findings revealed significantly different rates of gastritis and atrophy between the B12-deficient and control groups (P=0.017). B12-deficient patients had significantly less superficial gastritis (62% vs 94%) and significantly more atrophic gastritis (28% vs 0%) as compared to the controls (P=0.039). Intestinal metaplasia was similar in both groups. Helicobacter pylori infection rates were similar in the B12-deficient patients and controls (40% vs 31%). Conclusion: Significantly different endoscopic findings and types of gastritis could often be observed in the presence and absence of B12 deficiency. Atrophy, based on endoscopy, and atrophic gastritis, based on histopathology, suggest the presence of B12 deficiency. Gastric histopathology is not influenced by the age, gender, Hct or MCV of the patients.

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