Helicobacter pylori -: Is it a novel causative agent in vitamin B12 deficiency?

Background: Evidence for vitamin B-12 deficiency usually involves combinations of low serum vitamin B-12 levels, clinical and metabolic abnormalities, and therapeutic response. Identification of the underlying cause is important in the diagnosis of vitamin B-12 deficiency that is usually attributed to malabsorption. Helicobacter pylori is one of the most common causes of peptic ulcer disease worldwide and a major cause of chronic superficial gastritis 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-12 deficiency prospectively and to assess whether treatment for H pylori infection 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 gastrointestinal endoscopy was performed to assess the severity of atrophic gastritis and biopsy specimens for Campylobacter-like organisms tests and histological examination for H pylori were obtained at the time of diagnosis. The diagnosis 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 patients. Conclusions: Helicobacter pylori seems to be a causative agent in the development of adult vitamin B12 deficiency. Eradication of H pylori infection alone may correct vitamin B-12 levels and improve anemia in this subgroup of patients.