Helicobacter pylori - Is it a novel causative agent in vitamin B-12 deficiency?

Background: Evidence for vitamin B-12 deficiency usually involves combinati ons of low serum vitamin B-12 levels, clinical and metabolic abnormalities, and therapeutic response. Identification of the underlying cause is import ant in the diagnosis of vitamin B-12 deficiency that is usually attributed to malabsorption. Helicobacter pylori is one of the most common causes of p eptic ulcer disease worldwide and a major cause of chronic superficial gast ritis leading to atrophy of gastric glands. It is suggested that there may be a casual relationship between H pylori and food-cobalamin malabsorption. Objectives: To evaluate the H pylori incidence in patients with vitamin B-1 2 deficiency prospectively and to assess whether treatment for H pylori inf ection could correct this deficiency over time. Patients and Methods: We performed a prospective cohort study involving 138 patients who had anemia and vitamin B-12 deficiency. An upper gastrointest inal endoscopy was performed to assess the severity of atrophic gastritis a nd biopsy specimens for Campylobacter-like organisms tests and histological examination for H pylori were obtained at the time of diagnosis. The diagn osis of H pylori prompted a combination treatment. Results: Helicobacter pylori was detected in 77 (56 %) of 138 patients with vitamin Bit deficiency and eradication of H pylori infection successfully improved anemia and serum vitamin B-12 levels in 31 (40 %) of 77 infected p atients. Conclusions: Helicobacter pylori seems to be a causative agent in the devel opment of adult vitamin B12 deficiency. Eradication of H pylori infection a lone may correct vitamin B-12 levels and improve anemia in this subgroup of patients.