126
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Vinti H, Pesce A, Fuzibet JG, Gratecos N, Cassuto JP, Dujardin P. [Pernicious anemia in a beer drinker. Disclosing value of withdrawal]. Presse Med 1987; 16:1483. [PMID: 2957677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
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127
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Jones BP, Broomhead AF, Kwan YL, Grace CS. Incidence and clinical significance of protein-bound vitamin B12 malabsorption. Eur J Haematol 1987; 38:131-6. [PMID: 3595808 DOI: 10.1111/j.1600-0609.1987.tb01150.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Patient records from January 1975 to December 1984 were analysed to assess the possible incidence of protein-bound vitamin B12 malabsorption. This condition is characterised by a low serum vitamin B12 level and a normal Schilling test but impaired absorption of vitamin B12 bound to protein. We found that 48 (25%) patients with a low serum cobalamin level unexplained by other causes had a normal Schilling test. Megaloblastic haemopoiesis was found in 25 of these. From this group, all 10 patients who had a test of protein-bound vitamin B12 absorption showed impaired absorption. Protein-bound vitamin B12 malabsorption may represent an early phase of pernicious anaemia when hypochlorhydria precedes intrinsic factor deficiency and should be tested for when the serum vitamin B12 level is decreased and the Schilling test is normal.
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128
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Omboni E, Checchini M, Longoni F. [A case of recurrence of pernicious anemia]. Minerva Med 1987; 78:117-20. [PMID: 3808404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
A case of pernicious anaemia recurring after 14 years in a patient who had suspended parenteral vitamin B12 treatment two months after the first hospitalisation is described. The earliest haematological signs of vitamin B12 deficiency are examined and the apparent failure to absorb the vitamin B12 regularly taken with the diet when no longer administered parenterally is discussed.
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129
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Gogos CA, Kapatais-Zoumbos KN, Zoumbos NC. Lymphocyte subpopulations in megaloblastic anaemia due to vitamin B-12 deficiency. SCANDINAVIAN JOURNAL OF HAEMATOLOGY 1986; 37:316-8. [PMID: 2947316 DOI: 10.1111/j.1600-0609.1986.tb02319.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Lymphocyte subpopulations were measured in the blood of 17 patients with megaloblastic anaemia due to vitamin B-12 deficiency. 14 patients had pernicious anaemia and 3 others were gastrectomized. By using monoclonal antibodies recognizing T cell surface markers and immunofluorescence microscopy, we found a significant decrease in the number of circulating suppressor T cells and an increase in the ratio of helper to suppressor T lymphocytes in pernicious anaemia patients. This finding may be related to other immune abnormalities found in pernicious anaemia, e.g. the presence of multiple autoantibodies.
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130
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Leen CL, Birch AD, Brettle RP, Welsby PD, Yap PL. Salmonellosis in patients with primary hypogammaglobulinaemia. J Infect 1986; 12:241-5. [PMID: 3522750 DOI: 10.1016/s0163-4453(86)94216-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Three of 20 patients with primary hypogammaglobulinaemia developed Salmonella gastroenteritis. Two of them who also had low concentrations of serum IgG and pernicious anaemia were clinically septicaemic. Patients with primary hypogammaglobulinaemia have previously been thought not to be more susceptible to Salmonella infection but a combination of low gastric acidity and impaired humoral immunity may predispose them to such infection.
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131
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Gopinathan VP, Subramanian AR. Vivax and falciparum malaria seen at an Indian service hospital. THE JOURNAL OF TROPICAL MEDICINE AND HYGIENE 1986; 89:51-5. [PMID: 3534280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
The cases of 740 adult males with vivax and/or falciparum malaria managed in a military hospital in north-eastern India during the period from June 1978 to March 1981 were analysed. Four hundred and nine (55.3%) were infected with Plasmodium falciparum, 237 (32.0%) with P. vivax and the remaining 94 (12.7%) with both P. vivax and P. falciparum. The majority of cases were chloroquine sensitive and did not pose diagnostic or therapeutic problems. Of 381 patients subjected to an extended field test, 82 (21.5%) exhibited a variable degree of chloroquine resistance. Cerebral and haemopoietic involvement were the commonest of the pernicious syndromes observed in 92 (12.4%) patients. Atypical presentations, variable chloroquine resistance and presentation with complications call for timely recognition and institution of a specific supportive therapeutic regime.
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132
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Moses RE, Frank BB, Leavitt M, Miller R. The syndrome of type A chronic atrophic gastritis, pernicious anemia, and multiple gastric carcinoids. J Clin Gastroenterol 1986; 8:61-5. [PMID: 3517132 DOI: 10.1097/00004836-198602000-00013] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Gastric carcinoid tumors comprise approximately 1.0 to 2.7% of all carcinoid tumors. There appears to be an association between gastric carcinoids and pernicious anemia on the basis of underlying type A chronic atrophic gastritis. We review the relevant literature and describe a 63-year-old woman who had pernicious anemia and multiple polypoid gastric carcinoid tumors. The association of these disorders, proposed mechanisms of such association, and the need for an aggressive diagnostic approach are discussed.
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133
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Abstract
Immune disorders of the gastrointestinal tract and hepatobiliary systems comprise a diverse group of illnesses which share in common certain overlapping and yet distinctive expressions of cellular and humoral immunity. As is evident from material contained in this article, controversy and disparate results frequently characterize the study of immune mechanisms in a given disease process. Nonetheless, advances in quantitation of specific immunocyte function and phenotypic expression have greatly facilitated the depth of understanding of the immune process related to these disorders. Challenges for future clinical investigation of these disorders are to characterize cell-specific target antigens to which immunologic attack is directed and to unravel the immunogenetic mechanisms that trigger and direct immune-mediated injury to host tissues. It is anticipated that continued investigation of immune disorders of the gastrointestinal tract and liver will clarify pathogenetic mechanisms and thus permit formulation of rational and effective therapies.
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134
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Busby J, Caranasos GJ. Immune function, autoimmunity, and selective immunoprophylaxis in the aged. Med Clin North Am 1985; 69:465-74. [PMID: 3892187 DOI: 10.1016/s0025-7125(16)31026-4] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Many changes occur in the immune system with age. The involution of the thymus plays a major role in immune senescence. Related to this event are the altered ratio of helper to suppressor T-lymphocyte subsets, decrease in immune response by both cell-mediated and humoral branches of the immune system, and increase in autoimmune activity. The clinical implications of these changes are the elderly person's increased susceptibility to infections such as pneumococcal pneumonia, influenza A, and tetanus as well as increased autoimmune activity, reflected by pernicious anemia. Other changes may be increased susceptibility to neoplasms and perhaps acceleration of the aging process. A high index of suspicion should be present for the diagnosis of pernicious anemia in the elderly population. Knowledge of the many autoantibodies that might be present without illness is important when evaluating for disease processes. The relationship of the senescent immune system to the aging process is still unknown. Investigations of this matter, as well as of the function of immune system components and their relationship to disease processes, are continuing. Most methods proposed for enhancing the immune system are still experimental. However, immunizations have been proved to be an effective means of reducing morbidity and mortality from certain infectious diseases in the elderly. Therefore, it is strongly recommended that all elderly persons who are at risk for pneumococcal pneumonia, influenza, and tetanus receive the proper immunizations.
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135
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136
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Krein BM, Troncoso J, Kahn SB, Mancall EL. Irreversible neurologic degeneration secondary to vitamin B12 deficiency without anemia: report of a case. THE JOURNAL OF THE AMERICAN OSTEOPATHIC ASSOCIATION 1984; 84:348-50. [PMID: 6511511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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137
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Wörmann B, Ottenjann R. [Gastric mucosal polyps--an irrelevant finding? Studies on the incidence and clinical significance]. Dtsch Med Wochenschr 1984; 109:1753-6. [PMID: 6149921 DOI: 10.1055/s-2008-1069447] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Among about 20.000 patients who had a gastroscopy in a period of 6 years, 92 had gastric mucosal polyposis, diagnosed by endoscopy and histology, an incidence of 0.46%. Eight patients with an age average of 38 years had familial gastrointestinal adenomatosis, in six of them the criteria of Gardner's disease were fulfilled. The remaining 84 patients had an average age of 62 years. In patients with more than ten polyps the sex ratio (female to male) was 3.9:1. In 56 patients without familial gastrointestinal adenomatosis, coloscopy and(or) proctosigmoidoscopy was performed. In 18 there were polyps in the colon, in three an invasive carcinoma in an adenoma. In three further patients extensive carcinoma of the colon (in two with stenosis) was found. These observations suggest that patients with gastric mucosal polyposis have a higher incidence of colon polyps and carcinoma.
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138
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Tinker MA, Viswanathan B, Laufer H, Margolis IB. Acute appendicitis and pernicious anemia as complications of gastrointestinal sarcoidosis. Am J Gastroenterol 1984; 79:868-72. [PMID: 6507409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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139
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Mathew L, Lobel SA, Miale TD. The clinical diagnosis of megaloblastic anemias in infancy and childhood. Indian J Pediatr 1984; 51:429-42. [PMID: 6396231 DOI: 10.1007/bf02776431] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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140
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Laxén F. Gastric carcinoma and pernicious anaemia in long-term endoscopic follow-up of subjects with gastric polyps. Scand J Gastroenterol 1984; 19:535-40. [PMID: 6463578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
Abstract
The starting material consisted of 357 subjects with gastric polyps found at endoscopy. Histologically, these cases were divided in four groups: adenoma, 8%; hyperplastic polyp, 34%; foveolar hyperplasia, 21%; and inflammatory polyp, 36%. Of these 210 patients were for various reasons no longer available for follow-up study. Endoscopic follow-up study for about 8 years (range, 5-15.5 years) was performed in 147 patients. At the follow-up examination, in 103 patients morphologic signs and in 92 of these immunological and functional signs of pernicious anaemia were examined. The prevalences of severe atrophic gastritis affecting mainly the body mucosa (26%), parietal cell and/or intrinsic factor blocking antibodies (25%), low serum vitamin B12 levels (8%), and overt pernicious anaemia (treated and new cases, 11%) were significantly higher than in equal numbers of age- and sex-matched controls examined in a similar manner. Gastric cancer was found in 3 (2%) cases followed up for more than 5 years. This is seven times the expected incidence, with a 95% confidence interval of the risk ratio (1.5-20.9). The high frequency of gastric cancer and pernicious anemia emphasizes the importance of long-term endoscopic follow-up study of patients with gastric polyps.
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141
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Giugliani ER, Jorge SM, Gonçalves AL. Folate and vitamin B12 deficiency among parturients from Porto Alegre, Brazil. REVISTA DE INVESTIGACION CLINICA; ORGANO DEL HOSPITAL DE ENFERMEDADES DE LA NUTRICION 1984; 36:133-6. [PMID: 6484331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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142
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Tönissen R, Oevrenes A. [Chronic gastritis and pernicious anemia]. MMW, MUNCHENER MEDIZINISCHE WOCHENSCHRIFT 1984; 126:132,6. [PMID: 6422271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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143
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Castle WB, Ham TH. Landmark article Oct 31, 1936: Observations on the etiologic relationship of achylia gastrica to pernicious anemia. V. Further evidence for the essential participation of extrinsic factor in hematopoietic responses to mixtures of beef muscle and gastric juice and to hog stomach mucosa. By W.B. Castle and T.H. Ham. JAMA 1984; 251:514-21. [PMID: 6361304 DOI: 10.1001/jama.251.4.514] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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144
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Herbert V. Landmark perspective: An 'extrinsic factor' and pernicious anemia. JAMA 1984; 251:522-3. [PMID: 6361305 DOI: 10.1001/jama.251.4.522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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145
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Carney JA, Go VL, Fairbanks VF, Moore SB, Alport EC, Nora FE. The syndrome of gastric argyrophil carcinoid tumors and nonantral gastric atrophy. Ann Intern Med 1983; 99:761-6. [PMID: 6197001 DOI: 10.7326/0003-4819-99-6-761] [Citation(s) in RCA: 159] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Records of the 30 cases of gastric carcinoid at the Mayo Clinic showed that the gastric mucosa was normal, hyperplastic, or atrophic (nonantral) in 12, 2, or 16 patients, respectively. In the atrophic group, the tumors were in the gastric body and fundus; small, polypoid, and multicentric; and associated with fundal argyrophil cell hyperplasia. In immunocytochemical studies, minor tumor cell populations stained positively for 5-hydroxytryptamine, gastrin, and somatostatin in 1 case and for 5-hydroxytryptamine in 3 others. Metastasis occurred in 3 patients. Twelve patients had pernicious anemia. Parietal cell or intrinsic factor antibodies or both were present in all 12 patients tested. Each of the 7 patients with an intact antrum had massive hypergastrinemia. No common HLA-A, -B, or -DR antigen pattern was detected among the 10 patients tested. The results suggest that nonantral gastric atrophy predisposes to gastric carcinoid as well as to gastric carcinoma.
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146
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Goldfarb JP, Gross F, Maxfield R, Rubin M, Janis R. Gastric carcinoid: two unusual presentations. Am J Gastroenterol 1983; 78:332-4. [PMID: 6859010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
We report two cases of gastric carcinoid that presented as benign-appearing polyps. One presented with multiple, benign-appearing polyps--a particularly unusual presentation for an uncommon tumor. The second patient had a single polypoid gastric carcinoid and atropic gastritis with pernicious anemia. These atypical presentations and uncommon association of gastric carcinoid are discussed.
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147
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Goncharov AF, Karchevskaia TA. [Severe pernicious anemia caused by diphyllobothriasis]. VOENNO-MEDITSINSKII ZHURNAL 1983:68. [PMID: 6868438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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148
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Evans DL, Edelsohn GA, Golden RN. Organic psychosis without anemia or spinal cord symptoms in patients with vitamin B12 deficiency. Am J Psychiatry 1983; 140:218-21. [PMID: 6849439 DOI: 10.1176/ajp.140.2.218] [Citation(s) in RCA: 47] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
The authors describe two patients with organic psychosis who had vitamin B12 deficiency and no hematologic or spinal cord abnormalities. They review the literature that supports a causal relationship between B12 deficiency and cerebral dysfunction, as measured by the EEG, and consequent organic mental changes. The authors cite evidence that these EEG and organic mental changes are reversible with B12 replacement. They emphasize that psychiatric manifestations may be the first symptoms of vitamin B12 deficiency and thus antedate anemia and spinal cord disease. They recommend consideration of B12 deficiency and serum B12 determinations in all patients with organic mental symptoms.
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149
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Carmel R. Subtle cobalamin malabsorption in a vegan patient: evolution into classic pernicious anemia with anti-intrinsic factor antibody. ARCHIVES OF INTERNAL MEDICINE 1982; 142:2206-7. [PMID: 7138169 DOI: 10.1001/archinte.142.12.2206] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Classic pernicious anemia with abnormal Schilling test results developed in a previously described vegan patient who had coexisting subtle cobalamin malabsorption (demonstrable by abnormal ovalbumin-cobalamin absorption test results but normal Schilling test results). This suggests that the ovalbumin-cobalamin absorption test or a modified version may serve as a prodromal phenomenon to identify patients at risk for developing pernicious anemia. The patient's transformation was also accompanied by the appearance of serum anti-intrinsic factor antibody. A modified assay retrospectively detected this antibody a year earlier than did the standard assay, indicating that such modification enhances the sensitivity of this useful test.
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150
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Gohil P, Haynie RL, Spencer AM, Clark TH. Vitamin B12 neuropathy with pernicious anemia. Description and a case report. JOURNAL OF THE AMERICAN PODIATRY ASSOCIATION 1982; 72:73-8. [PMID: 7069114 DOI: 10.7547/87507315-72-2-73] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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