RT Journal
A1 Harriman GR, Smith PD, Home MK, et al
T1 VItamin b12 malabsorption in patients with acquired immunodeficiency syndrome
JF Archives of Internal Medicine
JO Archives of Internal Medicine
YR 1989
FD September 1
VO 149
IS 9
SP 2039
OP 2041
DO 10.1001/archinte.1989.00390090091018
UL http://dx.doi.org/10.1001/archinte.1989.00390090091018
AB • We have examined 11 patients with the acquired immunodeficiency syndrome (AIDS) for evidence of subclinical vitamin B12 malabsorption. Three subjects (27%) had low levels of vitamin B12. Eight subjects (73%), including these 3 subjects plus 5 others with normal vitamin B12 levels, had abnormal Schilling test results. In addition, 15% of an unselected population of 121 patients with AIDS and 7% of 27 patients without AIDS who were seropositive for human immunodeficiency virus type 1 (HIV-1) had low serum vitamin B12 levels. Stool cultures from the 8 subjects with abnormal Schilling test results revealed no pathogens. Intestinal involvement by Kaposi's sarcoma was found in only 1 patient. Biopsy specimens from 5 of 6 patients with vitamin B12 malabsorption, however, contained mononuclear cells harboring HIV-1, as indicated by in situ hybridization studies. Our observations suggest that vitamin B12 malabsorption is common in patients with AIDS and may be a very early manifestation of infection with HIV-1.(Arch Intern Med. 1989;149:2039-2041)