Shilling’s test is used to determine deficiency of
Correct Answer: Vitamin B12
Description: Answer is A (Vitamin B12) Shilling's test is done to determine the cause of cyanocobalamine deficiency (Vitamin B12). Schilling test is abnormal in conditions that affect cobalamine absorption including Pernicious anemia, Chronic Pancreatitis, Bacterial overgrowth syndrome and Heal dysfunction. Conditions with Abnormal Schilling's Test (Abnormal Cobalamine Absorption) Pernicious anemia Chronic Pancreatitis Achlorhydria Bacterial overgrowth syndrome Beal dysfunction Schilling Test: Schilling test is performed to determine the cause of cobalamine malabsorption (Vit B12 malabsorption). Since cobalamine absorption requires multiple steps including gastric, pancreatic and ileal processes, the Schilling test can also be used to assess the integrity of these other organs. The Schilling test is performed by administering Co58-labeled cobalamin orally and collecting urine for 24h 1 mg of cobabmine is administed intramuscularly one hour after ingestion of the Radiolabelled cobalamine. This is done to ensure saturation of cobalamine binding sites in the liver as urinary excretion of cobalamine will reflect cobalamine absorption only provided that intrahepatic binding sites of cobalamine are fully occupied. Once intrahepatic binding sites of cobalamine are saturated all absorbed radiolabelled cobalamine will be excreted in urine. The Schilling test may be abnormal (defined as less than 10 percent excretion in 241i) in conditions that affect cobalamine absorption including Pernicious anemia, Chronic Pancreatitis, Bacterial overgrowth syndrome and Heal dysfunction. The etiology for an abnormal Schilling test may be deduced by administering Co58-labeled cobalamin with intrinsic factor, pancreatic enzymes or after 5 day course of antibiotics. Differential Results of Schilling Test in various diseases associated with cobalamin malabsorption may thus help establish the diagnosis. Diagnosis 58Co-Chl With Intrinsic Factor With Pancreatic Enzymes After 5 Days of Antibiotics Pernicious anemia Reduced Normal Reduced Reduced Chronic pancreatitis Reduced Reduced Normal Reduced Bacterialovergrowth Reduced Reduced Reduced Normal Ileal disease Reduced Reduced Reduced Reduced
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