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A Syrian family is described with three children who had inherited selective vitamin B12 malabsorption associated with proteinuria. (Imerslund-Grasbeck syndrome). Although inherited the defect was apparently not present at birth. A third child had less severe vitamin B12 malabsorption, was not vitamin B12 deficient and had no proteinuria. Studies on two of the affected children with subcellular fractionation of the uptake of radioactive vitamin B12 by ileal tissue in vivo indicate a defect in the ileal receptors for IF-bound vitamin B12. These findings are different from the single in vitro experiment on a patient with this condition that has been previously reported. [ABSTRACT FROM PUBLISHER]

An assessment has been made of 25 patients who have undergone ileorectal anastomosis for Crohn's disease. The rate of anastomotic leakage was high (32%) but was fatal in only one patient. The likelihood of leakage was not affected by a safety valve ileostomy, failure to excise all diseased bowel, or steroid therapy. The overall recurrence rate was 60 per cent. This was not affected by the age of the patient, duration of the disease, steroid therapy, or anastomotic leak but was affected adversely by the presence of concurrent small bowel disease and by residual rectal disease at the site of the anastomosis. [ABSTRACT FROM PUBLISHER]

This study shows that faecal diversion by ileostomy or colostomy results in an improvement in the patient's general health which is substantiated by the haematological and biochemical findings. However, in the bowel distal to the diversion there is always histological evidence of mucosal and transmural disease and complications such as fistulae may still occur. In only two patients (7%) was restoration of bowel continuity successful. [ABSTRACT FROM PUBLISHER]