[Treatment of vitamin B 12 deficiency].
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In 5 normal persons, 1 patient with pernicious anemia, 5 patients with renal insufficiency in the state of compensation, and in one patient with chronic hemodialysis Schilling tests, activity of 57Co and vitamin B12 serum levels were measured. It was obvicous that activity of 57Co in serum 8 hours after oral application of 0.5 muCi 57Co-vitamin B12 showed reliable results to clear the problem of vitamin B12 malresorption. This method is easier than the Schilling test because the collection of 24-hour-urine is not necessary and an insufficiency of renal function does not influence the result.
Report on a case of severe megaloblastic anemia in a vegetarian, associated with marked erythroleukemic blood findings probably caused by infections (bronchopneumonia, asthmatic bronchitis, urinary tract infection) and severe heart failure. Successful treatment of the above mentioned complications resulted in almost complete disappearance of pathologic cells from the blood even before vitamin B12 treatment was started. With this therapy complete recovery was achieved and the signs suspect for erythroleukemia in blood and bone marrow disappeared definitively. The case also fulfilled all the criteria of pernicious anemia (Schilling's test and determination of intrinsic factor were not done).
Vitamin deficiency states are important in the genesis of many ocular disorders. Deficiencies may be due to poor dietary intake, or to alterations in metabolism produced by some commonly prescribed medications or by certain diseases. Furthermore, some vitamins may exert important pharmacologic effects on the normal eye. The ocular effects of deficiencies and excesses of specific vitamins, and the therapeutic uses of each vitamin, are reviewed.
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During the past 10 to 20 years it has become increasingly clear that a certain number of drugs may lead to increased vitamin requirements. However, it is unusual for symptomatic avitaminosis to develop, and then only when circumstances are present which in themselves increase the risk of vitamin deficiency. Therapeutic doses of drugs will interfere with the vitamin status only to a restricted degree, provided they are administered for brief periods and to patients receiving a normal supply of vitamins. Most cases of vitamin deficiency have in fact been described in connection with drugs usually taken for a longer period of time by patients who were already in negative vitamin balance as a result of disease or marginal supply of the necessary vitamins. This review describes some of the more important articles covering this topic.
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