how does pancreatitis cause macrocytic anemia? - smalik99

[ArchivalUser]

any theories?

[ArchivalUser]

Vitamin b12 deficiency from pancreatitis

[ArchivalUser]

come on brother zen..i need a proper usmle step 1 answer..haha

[ArchivalUser]

Lol I don't remember haha that's all I remember sorry! I'll wait for the answer as well !!! Lately just been going down hill!! :/

[ArchivalUser]

when B12 enters stomach ---> it binds to "HAPTOCORIN" (to protect it from the acidic environment) ---> in duodenum this complex (Hapto - Vit B 12) is broken down by a PANCREATIC enzyme so that Vit B12 can bind to IF and get reabsorbed.


In Pancreatic insufficiency ---> No enzyme to break the complex and digest HAPTOCORIN---> No binding of Vit B 12 to IF ---> No proper absorption---> Vit B 12 def.

[ArchivalUser]

in chronic pancreatitis u basically get malabsorption of fat soluble vitamins ie vit A,D,E,k..but for some reason u do see in a few percent of cases vit b12 deficiency..not much known why..i thinks its a low yield point..

[ArchivalUser]

Usmle8484 seems like u hit the mark! Thanks

[ArchivalUser]

right on usmle8484..in pathoma they call it R-binder..which im assuming is the same thing as haptocorin..well done!

[ArchivalUser]

wow!! thanks

[ArchivalUser]