For the purpose of investigating whether or not Co
60-B
12 absorption tests are successfully applicable to Japanese subjects, the intestinal absorption of orally administered Co
60-B
12 was studied for the first time on the Japanese patients suffering from hematologic disorders including Addisonian pernicious anemia as well as the normals. At the same time, in view of the fact that pernicious anemia is rare in Japan, an attempt was made to study the difference in B
12 metabolism between the Japanese and the European or the American pernicious anemia patients. As the methods for measuring intestinal absorption of B
12, fecal or urinary excretion tests and hepatic uptake method were used in this study. Prior to this study, some fundamental investigations were made on these methods. The results obtained are as follows:
1. In Japanese normals, fecal excretion was 29.0±9.0% of the radioactivity of the oral Co
60-B
12 on the average, urinary excretion 17.4±6.8%, and hepatic uptake 8.74±2.93%, showing a good agreement with those in the foreign normals.
2. The measurement of hepatic uptake presented the evidence that absorbed B
12 was preferentially taken up by the liver in the Japanese as well. It was also found that 0.2 or 0.5μg of Co
60-B
12 should be given as a test dose in urinary excretion test, since percentage urinary radioactivity was significantly decreased when the oral dose was raised above 1.0μg.
3. In hematologic disorders such as leukemia, aplastic anemia, iron deficiency anemia, hemolytic anemia, lupus erythematosus, or anemia due to the lodging of tape worm, there could be observed no significant defect in B
12 absorption.
4. However, in three cases of pernicious anemia in relapse or in remission, B
12 absorption was exceedingly abolished without exception, unless hog intrinsic factor concentrate was added. This fact indicates that the pathogenesis of pernicious anemia of the Japanese patients was quite identical with the patients of other countries.
5. In addition, a diagnostic availability of B
12 absorption tests for the differentiation of pernicious anemia from other resembling megaloblastic anemias was also referred to.
Thus, the author was led to the general conclusion that B
12 absorption test was also well applicable to Japanese subjects and that the mechanism of pernicious anemia was identical with each other, irrespective of the patients' nationality, no matter how low the incidence of pernicious anemia may be.
View full abstract