Tapeworm pernicious anemia is not so rare in the northern Europe. In Japan, no cases of tapeworm pernicious anemia have been reported, though cases of Diphyllobothriasis latum have been increasing recently. 11 cases of Diphyllobothriasis latum were given 0.25μg of
57Co-vitamin B
12-human gastric juice (0.5μCi), and 0.25μg of
58Co-vitamin B
12 (0.8μCi) through a Bilbao-Dotter tube inserted into the upper jejunum to know the vitamin B
12 kinetics. One hour later, a flushing dose of 1mg non-labelled vitamin B
12 was injected intramuscularly. The 24 hours urine was collected (Schilling test) to count
57Co and
58Co. 48 hours after the start of treatment, the modified method of Damaso de Rivas (Kihara) was performed to expell the worm, and the radioactivity (
57Co,
58Co) of the worm was counted to evaluate the uptake rate of vitamin B
12 by the worm. The results of Schilling test were as follows.
57Co-vitamin B
12-human gastric juice: 14.1±8.1% (x±SD), 5.8-25.3% (range),
58Co-vitamin B
12: 20.9±10.2% (3.0-31.9%). Abnormal values under 10% were found in only two cases each. The uptake rate of vitamin B
12 by the worm varied considerably among 11 cases, e.g.
57Co-vitamin B
12-human gastric juice: 8.6±8.4% (1.6-24.9%),
58Co-vitamine B
12: 11.8 ± 15.5% (1.0-50.4%). It is suggested that because these VB
12 uptake rates by the tapeworm are so samll, Japanese patients with Diphyllobothriasis latum tend not to develop tapeworm pernicious anemia.
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