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Diagnosis criteria cobalamin deficiency related to FCM syndrome:
-Low serum cobalamin levels (<200 pg/ml)
-Normal “standard” Schilling test (using free cyanocobalamin labelled with cobalt-57) or abnormal “modified” Schilling test (using protein-bound radioactive cobalamin)
- ‡
No dietary cobalamin deficiency (intake > at least at 2.5 to 5µg per day) |
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Presence of a predisposing or associated disorders:
-Atrophic gastritis, chronic H. pylori infection, gastrectomy, gastric by-pass
-Exocrine pancreatic insufficiency (mainly related to alcohol abuse)
-Chronic alcohol abuse
-Intake of antacids (H2-receptor antagonists or proton pump inhibitors) or biguanides (metformin)
-Microbial overgrowth, AIDS
-Sjögren’s syndrome, scleroderma
-“Idiopathic” (related to age?) |
‡: The “modified” Schilling test uses food-bound cobalamin (e.g. egg, chicken and
fish proteins…); today, these test are not available in clinical routine. |
