ABSTRACT
Context: The clinical consequences of excess vitamin B12 induced by multiple oral doses of cyanocobalamin are not well-known.Case details: A young woman was treated with multiple daily doses of 1 mg of cyanocobalamin for severe pernicious anemia. After a total dose of 12 mg, she developed acne, palpitations, anxiety, akathisia, facial ruddiness, headache, and insomnia. She improved two weeks after stopping the drug. There were no sequelae nor complications.Discussion: Although these symptoms of cobalamin toxicity were unexpected and unusual, the case reminds us that the administration of any drug is not entirely safe.
Subject(s)
Acne Vulgaris/chemically induced , Anemia, Pernicious/drug therapy , Vitamin B 12/toxicity , Acne Vulgaris/diagnosis , Adult , Anemia, Pernicious/blood , Anxiety/chemically induced , Anxiety/diagnosis , Dose-Response Relationship, Drug , Female , Humans , Injections, Intramuscular , Treatment Outcome , Vitamin B 12/administration & dosage , Vitamin B 12/blood , Vitamin B 12/therapeutic useABSTRACT
Anti-parietal cell (APC) antibodies and pernicious anemia (PA) were evaluated in patients with type 1 diabetes (n=75) and in controls. A higher frequency of APC (13.3%) and PA (4%) was found in cases than in controls (p=0.003), associated with other autoimmune diseases (p=0.003), but not with insulin or PTPN22 polymorphisms.
Subject(s)
Anemia, Pernicious/complications , Autoantibodies/blood , Diabetes Mellitus, Type 1/complications , Parietal Cells, Gastric/immunology , Adolescent , Adult , Anemia, Pernicious/blood , Case-Control Studies , Diabetes Mellitus, Type 1/blood , Ethnicity , Female , Humans , Insulin/genetics , Male , Protein Tyrosine Phosphatase, Non-Receptor Type 22/genetics , Young AdultABSTRACT
Classical hormones (present in blood circulation), neuro-endocrine agents (released in the neural synapses), paracrine substances (disseminated around neighbouring cells) and autocrine factors (acting upon its own generating cell) constitute the universe of gastrointestinal peptides. Early gastrointestinal endocrinology has progressed into the current "receptorology" age. Technological advances have naturally produced an almost alluvial amount of information. This review addresses to several features of gastrin, a member of the gastrin/cholecystokinin family: a) participation in the regulation of gastric acid secretion; b) secretory cells receptors; c) hypergastrinemia and its influence upon enterochromaffin-like cells in characteristic clinical situations; d) histamine release regulation; and e) gastrin receptors and their potential actions on normal and neoplastic colonic epithelium.