A 58-year-old woman has a gastric ulcer, achlorhydria, and vibration sense loss in the lower extremities. She has a megaloblastic anemia. What test would help support a diagnosis of pernicious anemia?
Response to injection of radioactive B12
Endoscopic retrograde cholangiopancreatography (ERCP)
Prothrombin time (PT)
Radiolabeled B12 given orally
The Schilling test is performed by giving radiolabeled B12 orally (after saturating the B12 stores by intramuscular B12 ). In pernicious anemia, less than 3% of the label is found in the 24-hour urine collection (N>7%). Hemoglobin electrophoresis will detect defects in a- or b-globin chain synthesis, as seen in thalassemia (Mediterranean anemia).
Stomach & Duodenum