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Inadequate secretion of intrinsic factor, resulting from lesions that destroy the gastric mucosa (which can be caused by ingestion of corrosives, extensive tumors, and conditions associated with gastric atrophy, such as multiple sclerosis, certain endocrine disorders, iron deficiency, and subtotal gastrectomy) Structural lesions leading to vitamin B 12 deficiency, including regional ileitis, ileal reactions, and malignancies Competition for vitamin B 12 by intestinal parasites or bacteria
When your vitamin B12 level is low, your level of MMA rises
Haematologica 87:550551 Acknowledgements The authors are extremely thankful to the staff of the hematology department for their assistance in gathering the patient files and sparing us the time to conduct this study
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