Anémies par carence en vitamine B12 chez le sujet âgé de plus de 75 ans : nouveaux concepts. À propos de 20 observations

Andrès, Emmanuel; Perrin, Anne; Kraemer, J.P.; Goichot, B.; Demengeat, C.; Ruellan, A.; Grünenberger, F.; Constantinesco, A.; Schlienger, J.-L.

doi:10.1016/s0248-8663(00)00250-2

Cited by 27 publications

(19 citation statements)

References 21 publications

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“…Other studies focusing on elderly people, particularly those who are in institutions or who are sick and malnourished, have suggested a higher prevalence of 30-40% [11,12]. Using stringent definition, we found that cobalamin deficiency had a prevalence of 5% in a group of patients followed or hospitalized in a tertiary reference hospital [8].…”

Section: Epidemiology Of Cobalamin Deficiencymentioning

confidence: 54%

“…Varying test sensitivities and specificities result from the lack of a precise 'gold standard' for the diagnosis of cobalamin deficiency, especially in elderly patients. The definitions of cobalamin deficiency used in this review are shown in Box 1 [7,8]. At present, cobalamin deficiency is often defined in terms of the value of serum cobalamin (<150 pmol/l or <200 pg/ml) and of homocysteine (>13 mol/l) and methyl malonic acid (>0.4 mol/l), two components of the cobalamin metabolic pathway.…”

Section: Definition Of Cobalamin Deficiencymentioning

confidence: 99%

“…Cobalamin metabolism is complex and requires many processes, any one of which, if not present, may lead to cobalamin deficiency [4,[13][14][15]. Once metabolized, cobalamin is a cofactor and coenzyme in many biochemical reactions, including DNA synthesis, methionine synthesis from homocysteine and conversion of propionyl into succinyl coenzyme A from methyl malonate [4,8,9]. A typical Western diet contributes 3-30 g of cobalamin per day towards the recommended dietary allowance set by the Food and Nutrition Board of the Institute of Medicine (US) of 2.4 g/day for adults and 2.6 to 2.8 g/day during pregnancy [16].…”

Section: Cobalamin Metabolism and Functionmentioning

confidence: 99%

“…Dietary causes of deficiency are limited to elderly people who are already malnourished, such as elderly patients living in institutions (they may consume inadequate amounts of vitamin B12-containing foods) or in psychiatric hospitals (strict vegetarian) [4,13]. Since the 1980s, the malabsorption of cobalamin has become rarer, owing mainly to the decreasing frequency of gastrectomy and surgical resection of the terminal small intestine [4,8,14]. Several disorders commonly seen in gastroenterology practice might, however, be associated with cobalamin malabsorption.…”

Section: Cobalamin Metabolism and Functionmentioning

confidence: 99%

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Update of Food-Cobalamin Malabsorption and Oral Cobalamin Therapy

Andrès¹,

Vidal-Alaball²,

Fédérici³

et al. 2009

TOGMJ

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Cobalamin (vitamin B12) deficiency is particularly common in the elderly (>65 years of age), but is often unrecognized because its clinical manifestations are subtle; however, they are also potentially serious, particularly from a neuropsychiatric and hematological perspectives. In the general population, the main causes of cobalamin deficiency are pernicious anemia and food-cobalamin malabsorption. Food-cobalamin malabsorption syndrome, which has only recently been identified, is a disorder characterized by the inability to release cobalamin from food or its binding proteins. This syndrome is usually caused by atrophic gastritis, related or unrelated to Helicobacter pylori infection, and long-term ingestion of antacids and biguanides. Management of cobalamin deficiency with cobalamin injections is currently well codified, but new routes of cobalamin administration (oral and nasal) are being studied, especially oral cobalamin therapy for food-cobalamin malabsorption.

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Section: Epidemiology Of Cobalamin Deficiencymentioning

confidence: 54%

Section: Definition Of Cobalamin Deficiencymentioning

confidence: 99%

Section: Cobalamin Metabolism and Functionmentioning

confidence: 99%

Section: Cobalamin Metabolism and Functionmentioning

confidence: 99%

See 2 more Smart Citations

Update of Food-Cobalamin Malabsorption and Oral Cobalamin Therapy

Andrès¹,

Vidal-Alaball²,

Fédérici³

et al. 2009

TOGMJ

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“…taux sérique < 200 pg.mL −1 (150 pmol.L −1 ) sur 2 prélè-vements [13] ; 2. taux sérique < 160 pg.mL −1 [90] ; 3. taux sérique < 200 pg.mL −1 et taux sérique de l'homocystéine totale < 13 pmol.L −1 ou taux de l'acide méthyl-malonique > 0, 4 µmol.L −1 en l'absence d'une insuffisance rénale, d'un déficit en folates ou en vitamine B6 [44] ; 4. taux sérique < 200 pg.mL −1 avec des signes cliniques neurologiques et/ou des anomalies hématologiques [76].…”

Section: Physiopathologie De La Carence En Vitamine B12 Définitions Dunclassified

Carence en vitamine B12 (1^repartie) : mise au point

Loup-Leuciuc

Loup

Lombardi

et al. 2011

Med Buccale Chir Buccale

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(Reçu le 12 mai 2011, accepté le 24 juin 2011) Mots clés : vitamine B12 / métabolisme / carence / manifestationsRésumé -Classiquement, la carence en vitamine B12 s'accompagne d'une anémie mégaloblastique, de manifestations neuropsychiatriques et d'une glossite de Hunter. En réalité, les manifestations sont protéiformes et chacune d'elles peut rester longtemps isolée. Les manifestations stomatologiques, souvent discrètes, peuvent précéder de plusieurs années les autres manifestations. Elles constituent parfois un signe d'appel pour le dépistage précoce de cette carence. Depuis une bonne dizaine d'années, la conception de la physiopathologie de la carence en vitamine B12 a beaucoup évolué : on a identifié le syndrome de non-dissociation de la vitamine B12 des protéines porteuses qui constitue maintenant la principale cause de carence en vitamine B12 et il a été démontré qu'on peut effectuer un traitement de la carence per os. Key words: vitamin B12 / metabolism / deficiency / manifestationsAbstract -Vitamin B12 deficency. Part 1: update and littérature review. Vitamin B12 deficiency is classically accompanied by a megaloblastic anemia, neuropsychiatric disorders and an Hunter glossitis. Clinical manifestations are indeed polymorphic and each may remain the only one for a long period of time. Stomatological manifestations, often mild, may precede the others of many years. They sometimes are the first sign to early diagnose this deficiency. Since the last ten years, the physiopathology of vitamin B12 deficiency has considerably changed. In fact, nowadays, the main cause is the syndrome of food cobalamin malabsorption. It has also been demonstrated that the deficiency may now treated by an oral cobalamin therapy.La vitamine B12 est une vitamine hydrosoluble qui a une structure chimique proche de celle de l'hème avec un atome central constitué par du cobalt, d'où le nom de cobalamine (Fig. 1).Elle existe sous plusieurs formes regroupées dans la famille des cobalamines : cyanocobalamine, hydroxocobalamine, mé-thylcobalamine et adénosylcobalamine. La cyanocobalamine et l'hydroxocobalamine sont les seules formes stables. On peut considérer que les recherches sur la vitamine B12 ont commencé au XIX e siècle avec la description d'une anémie mortelle, l'anémie pernicieuse, par Thomas Addison et Michael Anton Biermer. Vers 1920, George Whipple, George Minot et William Murphy, tous les trois Prix Nobel de médecine en 1934, ont démontré que des extraits de foie sous forme de compléments alimentaires étaient susceptibles de corriger certaines anémies. On en a conclu que les extraits de foie contenaient le facteur extrinsèque, en réalité de la vitamine

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