DIFFERENTIATION OF MACROCYTIC ANEMIAS AND DIAGNOSIS OF PERNICIOUS ANEMIA AND SPRUE IN REMISSION BY ACCELERATED MEASUREMENT OF HEPATIC UPTAKE OF RADIOACTIVE Co^60B_12

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Abstract
The authors have simplified and accelerated the method of measurement of hepatic uptake of radioactive Co60B12 so as to make it adaptable for the clinical use. The method, in its accelerated form, allows one to rule out pernicious anemia in 48 hours and to make a diagnosis of pernicious anemia or sprue within 2-4 days, without regard to the previous treatment or to the stage of the disease. In time requirement it matches the urinary flushing test and is not subject to errors due to the inadvertent discarding of a urinary specimen by the patient and can be performed in any clinical isotope laboratory. The actual single measurement takes only 30 minutes. The hepatic uptake of radioactive Co60B12 is normal in anemias due to blood loss, hemolytic anemias, and nutritional macrocytic anemias due to dietary deficiency in folic acid or B12. On the contrary, the hepatic uptake is either entirely abolished or found only in traces in patients with pernicious anemia in relapse, remission, or in the preanemic stage, but it can then be corrected by the addition of intrinsic factor. In sprue, and in some cases of regional enteritis the hepatic uptake is also zero or appears only in traces, but it cannot be corrected by the addition of intrinsic factor. The measurement of hepatic uptake of CO6OB12 aids in the differentiation of various types of macrocytic anemias, detection or ruling out of pernicious anemia both in relapse and remission, diagnosis of oligosymptomatic sprue, and differentiation of simple anacidity from that due to the gastric atrophy of pernicious anemia in the non-anemic or the preanemic stage.