Studies of Vitamin B12 Metabolism in Patients with Chronic Hepatitis and Liver Cirrhosis^[*]

Summary

We have studied the kinetiks of vitamin B₁₂ and especially the liver compartment, in 28 normals and 76 patients with chronic hepatitis and liver cirrhosis.

The study was carried out by means of vitamin B₁₂ ⁵⁸Co, administered per os (alone or followed by “flushing dosis”), vitamin B₁₂ ⁵⁷Co administered intravenously and by double tracer technique.

Our results indicate the Pertubation of intrahepatic storage compartment of radiocobalamine, in patients with chronic hepatitis and especially in patients with active hepatitis and in cirrhotics.

This deficiency can be explained probably, by an alteration of the transport to the liver of the absorbed vitamin B₁₂, by an inadequate chemical forme, by hepatic enzymatic disturbances or by excessive handling and storage in extrahepatic compartment.

Nous avons étudié la cinétique de la vitamine B₁₂ et spécialement le compartiment hépatique chez 28 normaux et 76 malades avec une hépatite chronique ou une cirrhose du foie. L’étude a été effectuée à l’aide de la vitamine B₁₂ ⁵⁸Co, administrée per os (seule ou suivie d’une „flushing dosis”), de la vitamine B₁₂ ⁵⁷Co administrée par voie endoveineuse et par la technique du double traceur.

Nos résultats indiquent une perturbation du compartiment de depot hépatique de la radiocobalamine chez les malades hépatiques et spécialement dans les formes évolutives et dans les cirrhoses.

Ces troubles s’expliquent probablement par une altération du transport de la vitamine B₁₂ absorbée vers le foie, par une forme chimique inadéquate, par des troubles hépatiques enzymatiques et par la fixation extra-hépatique excessive.

Die Kinetik des Vitamin B₁₂, besonders im Lebercompartment, wurde bei 28 Normalen und 76 Leberkranken (chronische Hepatitis und Zirrhose) mit radioaktivem Vitamin B₁₂ untersucht. Es wurde ⁵⁸Co Vitamin B₁₂ per os verabreicht (mit und ohne „flushing dosis”) oder ⁵⁷Co Vitamin B₁₂ injiziert; in einigen Fällen wurden beide Vitamine verabreicht und mit der Doppeltracer-Technik verfolgt.

Die Ergebnisse zeigen eine Störung des Leberdepotcompartments für Radiocobalamine bei den Leberkranken, besonders bei evolutiver Hepatitis und Zirrhose.

Es werden die Bedeutung der Absorptionsstörungen, des Transports zur Leber, der intrahepatischen enzymatischen Bindungen und der großen extrahepatischen Speicherung besprochen, die die Störungen des metabolischen Lebercompartments des Vitamin B₁₂ bei Leberkranken erklären könnten.

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