Reproducibility and reliability of the Schilling test
Journal/Book: Reprinted from THE JOURNAL OF LABORATORY AND CLINICAL MEDICINE St. Louis Vol. 58 No. 1 Pages 67-75 July 1961 (Copyright (c) 1961 by The C. V. Mosby Company) (Printed in the U. S. A.). 1961;
Abstract: J. F. ADAM V.R.D. M.B. CH.B. F.R.F.P.S. M.R.C.P.E. D.R.C.O.G. and D. A. SEATON M.B. CH.B. F.R.F.P.S. M.R.C.P.E. D.R.C.O.G. Glasgow and Edinburgh Scotland From the Western Infirmary Glasgow and the Royal Infirmary Edinburgh Scotland. Received for publication Sept. 6 1960. The reproducibility and reliability of the Schilling test in the same individual have been assessed by a study involving repeated Schilling tests in 7 patients with pernicious anemia 2 patients who had undergone total gastrectomy and one patient with adult celiac disease. The test was found to be reliable and reproducible in demonstrating malabsorption of Co58-labeled vitamin B12 in patients with pernicious anemia and in those who had undergone a total gastrectomy; a wide range of results was obtained in the patient with celiac disease. When Schilling tests were performed with intrinsic factor in the patients with pernicious anemia and in those who had undergone total gastrectomy there was evidente that the effect differed not only from patient to patient but also in the same patient at different times. The test with intrinsic factor was not reliable unless the dose of the factor was adequate. Difficulties of determining an adequate dose of intrinsic factor are outlined and illustrated by the results. There appeared to be an absorption defect in patients who had undergone total gastrectomy which differs from that found in patients with pernicious anemia. Oral calcium did not increase the absorption of vitamin B12 in the patient with celiac disease.