Reliability of the dual-isotope Schilling test for the diagnosis of pernicious anemia or malabsorption syndrome

Journal Article · Fri May 01 04:00:00 EDT 1981 · Am. J. Clin. Pathol.; (United States)

DOI:https://doi.org/10.1093/ajcp/75.5.723· OSTI ID:5706568

Domstad, P A; Choy, Y C; Kim, E E; DeLand, F H

To evaluate the dual-isotope Schilling test for the diagnosis of pernicious anemia or malabsorption syndrome, 65 studies were selected for clinical correlation. Criteria for pernicious anemia included mean corpuscular volume greater than 100 cu micrometer, serum B12 greater than 100 ng/l, megaloblastic marrow, achlorhydria, reticulocytes greater than 5% on B12 therapy, atrophic gastritis, and elevated serum antibodies to parietal cells or intrinsic factor. Criteria for malabsorption syndrome included: decreased serum B12, folate, and carotene; increased fecal fat; abnormal D-xylose absorption; abnormal radiographic and biopsy findings. /sup 58/Co-cyanocobalamin and /sup 57/Co-cyanocobalamin bound to intrinsic factor were given orally to fasting patients; 1 mg of nonradioactive B12 was injected intramuscularly within two hours. Aliquots of 24-hour urine samples were counted. If the excretion of /sup 58/Co was less than 7% and the /sup 57/Co//sup 58/Co ratio was greater than 1.7, the test indicated pernicious anemia; a ratio less than 1.7 indicated malabsorption syndrome. Sensitivity, specificity, and accuracy of the dual-isotope Schilling test were 83%, 98%, and 94% for pernicious anemia, and 67%, 90%, and 86% for malabsorption syndrome, respectively.

• OSTI ID: 5706568
• Journal Information: Am. J. Clin. Pathol.; (United States), Journal Name: Am. J. Clin. Pathol.; (United States) Vol. 75:5; ISSN AJCPA
• Country of Publication: United States
• Language: English

Related Subjects

550601* -- Medicine-- Unsealed Radionuclides in Diagnostics
62 RADIOLOGY AND NUCLEAR MEDICINE
ABSORPTION
ANEMIAS
BETA DECAY RADIOISOTOPES
BETA-PLUS DECAY RADIOISOTOPES
COBALT 57
COBALT 58
COBALT ISOTOPES
DAYS LIVING RADIOISOTOPES
DIAGNOSIS
DISEASES
DRUGS
DUAL-ISOTOPE SUBTRACTION TECHNIQUE
ELECTRON CAPTURE RADIOISOTOPES
HEMATINICS
HEMATOLOGIC AGENTS
HEMIC DISEASES
HOURS LIVING RADIOISOTOPES
INTERMEDIATE MASS NUCLEI
INTERNAL CONVERSION RADIOISOTOPES
INTESTINAL ABSORPTION
ISOMERIC TRANSITION ISOTOPES
ISOTOPE APPLICATIONS
ISOTOPES
METABOLIC DISEASES
METABOLISM
NUCLEI
ODD-EVEN NUCLEI
ODD-ODD NUCLEI
PATIENTS
RADIOISOTOPES
SYMPTOMS
TRACER TECHNIQUES
UPTAKE
VITAMIN B GROUP
VITAMIN B-12
VITAMINS