title: Low serum vitamin B12 is common in coeliac disease and is not due to autoimmune gastritis.
abstract: OBJECTIVE
  Although coeliac disease is a disorder of the proximal small bowel, associated vitamin B12 deficiency has been reported. This study aimed to assess the prevalence of B12 deficiency in a large series of coeliac patients, and to exclude the possibility that it is due to associated autoimmune gastritis.
  
  
  METHODS
  Prospective routine measurement of serum B12 in coeliac patients, with investigations for pernicious anaemia/autoimmune gastritis in B12-deficient patients.
  
  
  METHODS
  Gastroenterology department of a large district general hospital.
  
  
  METHODS
  If they were not taking vitamin B12 supplements already, patients had serum B12 measured before starting dietary gluten exclusion. Those with low levels also had gastric biopsies taken and plasma gastrin and serum gastric parietal cell and intrinsic factor antibodies measured.
  
  
  METHODS
  Prevalence of low serum B12, and presence or absence of indicators of pernicious anaemia/autoimmune gastritis in patients with low serum B12.
  
  
  RESULTS
  Of 159 patients, 13 had low serum B12 at diagnosis. A further six had been receiving B12 replacement therapy for 3-37 years before diagnosis, giving an overall prevalence of 12% (19 patients). Only 2/19 patients had gastric corpus atrophy, one with intrinsic factor antibodies and the other with hypergastrinaemia. There was no relationship between low B12 and clinical characteristics.
  
  
  CONCLUSIONS
  Low B12 is common in coeliac disease without concurrent pernicious anaemia, and may be a presenting manifestation. B12 status should be known before folic acid replacement is started.
authors.affiliation: Department of Gastroenterology, Altnagelvin Hospital, Londonderry BT47 6SB, Northern Ireland. wildickey@aol.com
authors.forename: William
authors.initials: W
authors.lastname: Dickey
mesh_terms: D000328:Adult; D002446:Celiac Disease / Q000097:blood* / Q000150:complications / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D014805:Vitamin B 12 / Q000097:blood*; D014806:Vitamin B 12 Deficiency / Q000209:etiology
chemical_list: D014805:Vitamin B 12