The importance of the deficiency in gastric secretion in the etiology of pernicious anemia has been established by the work of Castle and his associates. It is still a debatable question whether in this disease there is also a disturbance in the external secretory function of the pancreas. Anemia due to pancreatic disease has been sporadically described in the literature.1
Villa,2 on the basis of the determination of fat, protein and trypsin in the feces, concluded that in pernicious anemia, depending on the severity of the disease, there is not only gastric achylia but also intestinal achylia and, in particular, pancreatic achylia. Landau and Glass3 reported nine cases with both gastric and pancreatic achylia; however, they stated that the condition is rare. Cheney and Niemand,4 as a result of determining trypsin in the gastric contents after fasting, believed that pancreatic insufficiency might be of etiologic importance
HELMER OM, FOUTS PJ, ZERFAS LG. GASTRO-INTESTINAL STUDIES: III. DETERMINATIONS OF ENZYMES ON AUTOPSY SPECIMENS FROMCASES OF PERNICIOUS ANEMIA AND PELLAGRA. Arch Intern Med (Chic). 1934;53(5):675–679. doi:https://doi.org/10.1001/archinte.1934.00160110044003
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