The response to prednisolone in atrophic gastritis: a possible effect on non-intrinsic factor-mediated vitamin B 12 absorption.

The administration of prednisolone did not affect absorption of vitamin B(12) and gastric secretion of intrinsic factor in nine subjects with normal gastric mucosa, or in five with chronic superficial gastritis. No gastric morphological changes were observed in either group. In contrast, four of seven patients with pernicious anaemia showed improvement in absorption of vitamin B(12) during prednisolone administration for periods of two to 10 months. No consistent changes in gastric mucosal morphology were noted. An additional five patients were studied intensively during one month of prednisolone administration. In three, absorption of vitamin B(12) was restored to within the normal range between eight and 13 days after the commencement of the drug. The improvement was not paralleled by enhancement of secretion of intrinsic factor or other vitamin B(12) binders. Suppression of intrinsic factor antibodies in serum and gastric juice did not occur consistently in those patients showing a functional response.