Vitamin-B<sub>12</sub>-Resorptionsstörungen bei PAS-Therapie

Bleifeld, W.; Gehrmann, G

doi:10.1055/s-0028-1113418

Cited by 6 publications

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“…The primary nature of the PAS-induced malabsorption of vitamin B12 has thus far been obscure. The intrinsic factor seems to remain intact (Heinivaara & Palva 1965, Bleifeld & Gehrmann 1965, Palva & Heinivaara 1966, and no disturbance of the "releasing factor" has been found (Palva & Heinivaara 1966). No general malabsorption is involved, and the disturbance seems to affect vitamin B12 selectively (Heinivaara et al 1964).…”

Section: Discussionmentioning

confidence: 99%

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Drug‐Induced Malabsorption of Vitamin B₁₂ III. Interference of PAS and Folic Acid in the Absorption of Vitamin B₁₂

Palva

Heinivaara

Mattila

1966

Scandinavian Journal of Haematology

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In 22 patients with lowered Schilling test values during treatment with PAS a new Schilling test was performed with folic acid (FA) as additive. In the 9 patients with original Schilling test values of less than 5 per cent the mean value rose from 3.7 to 7.2 per cent when FA was added. In the 13 patients with values of 5 to 9 per cent the mean excretion rose from 6.9 to 10.7 per cent. In 18 patients suffering from B12 malabsorption for other reasons than PAS‐treatment the addition of FA failed to improve the Schilling test values. A competitive inhibition of FA is believed to be an important reason for PAS‐induced malabsorption of vitamin B12. It is further concluded that FA may play a role in the transport mechanism of B12 through the intestinal wall.

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Section: Discussionmentioning

confidence: 99%

“…The malabsorption of vitamin BI2 caused by para-aminosalicylic acid (PAS) , Bleifeld & Gehrmann 1965 seems to be quite selective and localized in the wall of the small intestine. It has been assumed that a metabolic effect of PAS, probably inhibition of an enzymatic mechanism, is involved , 1966.…”

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confidence: 99%

Drug‐Induced Malabsorption of Vitamin B₁₂ III. Interference of PAS and Folic Acid in the Absorption of Vitamin B₁₂

Palva

Heinivaara

Mattila

1966

Scandinavian Journal of Haematology

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“…Nachdem somit Durchfi~lle als Ursache der Malabsorption unwahrscheinlich sind, muI~ eine Schiidigung der Ileumzotten, wie sie in verschiedenem Ausma]~ bei den verschiedenen Formen des Malabsorptionssyndroms beschrieben wurde [4], in erster Linie in Betracht gezogen werden. Stewart [44] [11].…”

Section: Langzeitstudie (Abb 7)unclassified

Intestinale Absorptionsst�rung infolge metforminbehandlung (Zur Frage der Wirkungsweise der Bignanide)

et al. 1969

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Disturbance of intestinal absorption following metformin therapy (observations on the mode of action of biguanides)Summary. Urinary excretion of vitamin BI~ and Dxylose, and the levels of blood lipids were determined in 21 patients with clinical or chemical diabetes mellitus and obesity, before and 10 days after metformin treatment. In addition, fat tolerance and fat balance studies were carried out in 7 patients. In a long term study of 9 patients, the Schilling test was repeated 2--3 months after the beginning of the metformin treatment in a) 7 patients with permanent metformin treatment, and b) 2 patients after cessation of initial metformin treatment. The results were as follows: vitamin B~ and D-xylose absorptions were pathologically low after metformin treatment. Blood lipids and body weight were reduced. There was also some indication of disturbed fat absorption, which, however, could not be proved. Based on our results, it is possible that the decrease in blood sugar after treatment with metformin is partly induced by malabsorption of glucose. Thus the concept of Sadow on the effect of metformin on carbohydrate metabolism has to be re~valuated. The clinical implications of the results, especially with respect to vitamin Bla absorption are discussed.

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“…A reversible malabsorption of vitamin Bls has been detected in connection with treatment with certain drugs: anticonvulsants (Lees 1961, Reynolds et al 1965, colchicine (Webb et al 1968), PAS (Heinivaara & Palva 1964, Bleifeld & Gehrmann 1965 and KC1 (Salokannel et al 1970). In the last mentioned case, an acid intestinal contents with pH level under 6 have been found to be the mechanism of Bla malabsorption (Palva et al 1971).…”

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Drug‐Induced Malabsorption of Vitamin B₁₂: V. Intestinal pH and Absorption of Vitamin B₁₂during Treatment with Para‐Aminosalicylic Acid

Palva

Rytkönen

Alatulkkila

et al. 1972

Scandinavian Journal of Haematology

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The pH in the contents of the ileum was measured radiotelemetrically in 11 patients taking PAS for pulmonary tuberculosis and having subnormal Schilling test values. In 8 cases, the pH was above 6. At that level the intrinsic factor has been found to enhance the uptake of B12 in the ileal mucosa. The present finding is in agreement with earlier studies, indicating that PAS does not interfere with the intrinsic factor by any means, but causes B12 malabsorption by another mechanism.

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Vitamin-B₁₂-Resorptionsstörungen bei PAS-Therapie

Cited by 6 publications

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Drug‐Induced Malabsorption of Vitamin B₁₂ III. Interference of PAS and Folic Acid in the Absorption of Vitamin B₁₂

Drug‐Induced Malabsorption of Vitamin B₁₂ III. Interference of PAS and Folic Acid in the Absorption of Vitamin B₁₂

Intestinale Absorptionsst�rung infolge metforminbehandlung (Zur Frage der Wirkungsweise der Bignanide)

Drug‐Induced Malabsorption of Vitamin B₁₂: V. Intestinal pH and Absorption of Vitamin B₁₂during Treatment with Para‐Aminosalicylic Acid

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Vitamin-B12-Resorptionsstörungen bei PAS-Therapie

Cited by 6 publications

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Drug‐Induced Malabsorption of Vitamin B12 III. Interference of PAS and Folic Acid in the Absorption of Vitamin B12

Drug‐Induced Malabsorption of Vitamin B12 III. Interference of PAS and Folic Acid in the Absorption of Vitamin B12

Intestinale Absorptionsst�rung infolge metforminbehandlung (Zur Frage der Wirkungsweise der Bignanide)

Drug‐Induced Malabsorption of Vitamin B12: V. Intestinal pH and Absorption of Vitamin B12during Treatment with Para‐Aminosalicylic Acid

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Vitamin-B₁₂-Resorptionsstörungen bei PAS-Therapie

Drug‐Induced Malabsorption of Vitamin B₁₂ III. Interference of PAS and Folic Acid in the Absorption of Vitamin B₁₂

Drug‐Induced Malabsorption of Vitamin B₁₂ III. Interference of PAS and Folic Acid in the Absorption of Vitamin B₁₂

Drug‐Induced Malabsorption of Vitamin B₁₂: V. Intestinal pH and Absorption of Vitamin B₁₂during Treatment with Para‐Aminosalicylic Acid